Individual
LEEANN LIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
726 DOVER PL, CHAMPAIGN, IL 61820-7032
(217) 722-6733
Mailing address
726 DOVER PL, CHAMPAIGN, IL 61820-7032
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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