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1972798890
DEETRA MICHELLE MASON
CHAMPAIGN, IL
NPI
1972798890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2007-09-13
Last Update Date
2007-09-13
Business Address
-- DEETRA MICHELLE MASON
202 W PARK AVE
CHAMPAIGN, IL 61820-3929
Phone number: 217-373-2436
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Mailing Address
-- DEETRA MICHELLE MASON
202 W PARK AVE
CHAMPAIGN, IL 61820-3929
Phone number: 217-373-2436
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