Individual
MRS. CHARISSA LOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
652 COUNTY ROAD 180, CARTHAGE, MO 64836-7625
(417) 359-7085
Mailing address
710 LYON ST, CARTHAGE, MO 64836-1700
(417) 359-7000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014018049
MO
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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