Individual
DIANA LESMES PALACIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1613 VALLEY RD APT A1, CHAMPAIGN, IL 61820-7127
(217) 721-1944
Mailing address
1613 VALLEY RD APT A1, CHAMPAIGN, IL 61820-7127
(217) 721-1944
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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