Individual
XUAN LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
401 W SPRINGFIELD AVE, CHAMPAIGN, IL 61820-4716
(217) 398-8464
Mailing address
3308 HALIFAX DR, UNIT A, CHAMPAIGN, IL 61822-5214
(504) 858-3924
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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