Light, Domica Shanta

Light, Domica Shanta is an sole proprietor health care provider with primary practice located at 202 W Park Ave , Champaign IL 61820-3929. She recently has only one registered license in Agencies / Case Management, which is considered as her primary health care specialty. Light, Domica Shanta can be contacted via phone (217) 373-2430.

Contact Information

Primary practice address
202 W Park Ave Champaign IL 61820-3929
Phone: (217) 373-2430
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1972890499
LBN Legal business name Light, Domica Shanta
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2011
Last updated Jul 5th, 2011 - about 15 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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