Individual
CHARLENE NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2428
(217) 373-2445
Mailing address
709 BARDEEN LN, CHAMPAIGN, IL 61822-1057
(217) 355-5652
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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