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Individual

SHANIA LYNN DVORAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
2302 MORELAND BLVD, CHAMPAIGN, IL 61822-1398
(217) 356-7576
Mailing address
453 LANCASTER DR, PINGREE GROVE, IL 60140-9155

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150113226
IL

Other

Enumeration date
02/15/2024
Last updated
02/15/2024
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