Mason, Deetra Michelle

Mason, Deetra Michelle is an individual health care provider with primary practice located at 202 W Park Ave , Champaign IL 61820-3929. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Mason, Deetra Michelle can be contacted via phone (217) 373-2436.

Contact Information

Primary practice address
202 W Park Ave Champaign IL 61820-3929
Phone: (217) 373-2436
Fax: (217) 373-2444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1972798890
LBN Legal business name Mason, Deetra Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2007
Last updated Sep 13th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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