Individual
CARLA CARLOCK-SELF
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
(903) 535-7386
Mailing address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
(903) 535-7386
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16727
TX
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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