Individual
MUGE DIZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1813 W KIRBY AVE, CHAMPAIGN, IL 61821-5410
(217) 383-1850
(217) 383-3439
Mailing address
PO BOX 6002, URBANA, IL 61803-6002
(217) 326-8630
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071008300
IL
Other
Enumeration date
04/22/2013
Last updated
05/09/2013
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