KANISHA WALLACE

CHAMPAIGN, IL
NPI1740541341
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
Enumeration Date2012-05-31
Last Update Date2012-05-31
Business Address
-- KANISHA WALLACE
401 W SPRINGFIELD AVE
CHAMPAIGN, IL 61820-4716
Phone number: 217-398-8464
Mailing Address
-- KANISHA WALLACE
401 W SPRINGFIELD AVE
CHAMPAIGN, IL 61820-4716
Phone number:
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