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Individual

MRS. CARLA EVONNE BOUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
812 S VIRGINIA AVE, BELLEVILLE, IL 62220-3689
(618) 236-2482
Mailing address
812 S VIRGINIA AVE, BELLEVILLE, IL 62220-3689
(618) 236-2482

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180013435
IL
222Q00000X
Developmental Therapist

Other

Enumeration date
04/10/2007
Last updated
03/28/2025
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