Individual
DR. CARISSA LYN BOKELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4640 S CARROLLTON AVE, SUITE 235, NEW ORLEANS, LA 70119-6051
(504) 780-1702
(504) 780-1705
Mailing address
4640 S CARROLLTON AVE, SUITE 235, NEW ORLEANS, LA 70119-6051
(504) 780-1702
(504) 780-1705
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1048
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307424
—
LA
Enumeration date
10/10/2007
Last updated
02/24/2011
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