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1629529649
TIARA IVY
CHAMPAIGN, IL
NPI
1629529649
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2016-10-14
Last Update Date
2016-10-14
Business Address
-- TIARA IVY
1801 FOX DR
CHAMPAIGN, IL 61820-7236
Phone number: 217-398-8080
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Mailing Address
-- TIARA IVY
401 W SPRINGFIELD AVE
CHAMPAIGN, IL 61820-4716
Phone number: 217-398-8464
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