Individual
HOLLY N MIRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1818 E. WINDSOR ROAD, PSYCHIATRY/PSYCHOLOGY, CHAMPAIGN, IL 61802
(217) 255-9700
(217) 255-9650
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071003869
IL
Other
Enumeration date
07/28/2006
Last updated
05/07/2014
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