Individual
MRS. LECHRISTIEN RENEE BOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
839 BROADWAY, STE. 104, GARY, IN 46402-2414
(219) 882-4010
(219) 882-0210
Mailing address
839 BROADWAY, STE. 104, GARY, IN 46402-2414
(219) 882-4010
(219) 882-0210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
193200000X
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201241590A
—
IN
Enumeration date
08/28/2015
Last updated
08/28/2015
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