Individual
CARISSA LOPEZ-BOCKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
4107 E WASHINGTON ST, INDIANAPOLIS, IN 46201-4538
(317) 375-0203
Mailing address
132 N GLADSTONE AVE, INDIANAPOLIS, IN 46201-3604
(937) 474-2155
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000226A
IN
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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