Organization
BONITA STREETMAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONITA LEE STREETMAN M.S., LCSW, LCAC (CLINICAL COUNSELOR)
(317) 446-4125
Entity
Organization
Contact information
Practice address
2633 E 136TH ST, CARMEL, IN 46032-1855
(317) 446-4125
Mailing address
1445 DOMINION DR, ZIONSVILLE, IN 46077-1872
(317) 446-4125
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
34002619A
IN
251S00000X
Community/Behavioral Health Agency
87000793A
IN
Other
Enumeration date
01/14/2017
Last updated
01/14/2017
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