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1003254996
MARY KUBALANZA
CHAMPAIGN, IL
NPI
1003254996
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: IL 242002571)
Enumeration Date
2013-06-13
Last Update Date
2013-06-13
Business Address
MARY KUBALANZA
2001 S OAK ST SUITE B
CHAMPAIGN, IL 61820-0911
Phone number: 217-333-2205
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Mailing Address
MARY KUBALANZA
401 W PENNSYLVANIA AVE
URBANA, IL 61801-4920
Phone number:
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