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1588702179
SANDRA C LEISTER
CHAMPAIGN, IL
NPI
1588702179
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: IL 071004347)
Enumeration Date
2007-02-03
Last Update Date
2007-07-08
Business Address
-- SANDRA C LEISTER
701 DEVONSHIRE DR
CHAMPAIGN, IL 61820-7337
Phone number: 217-352-2672
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Mailing Address
-- SANDRA C LEISTER
1808 BENTBROOK DR
CHAMPAIGN, IL 61822-9218
Phone number: 217-352-2644
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