Deetra Michelle Mason
Deetra Michelle Mason is a Counselor in Champaign, Illinois. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
202 W Park AveChampaign, IL 61820-3929
Phone: (217) 373-2436
Fax: (217) 373-2444
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1972798890 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 13, 2007 |
| Last updated in NPPES | September 13, 2007 |
| Mailing address | 202 W Park Ave, Champaign, IL 61820-3929 |
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