Individual
LISA DIANE CARRICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6640 INTECH BLVD STE 195, INDIANAPOLIS, IN 46278-2014
(317) 295-0608
(317) 295-0622
Mailing address
6640 INTECH BLVD STE 195, INDIANAPOLIS, IN 46278-2014
(317) 295-0608
(317) 295-0622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002668A
IN
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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