| Bonita Streetman, Llc | |
|
2633 E 136th St Carmel IN 46032-1855 | |
| (317) 446-4125 | |
| Not Available |
| Full Name | Bonita Streetman, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2633 E 136th St, Carmel, Indiana |
| Authorized Official Name and Position | Bonita Lee Streetman (CLINICAL COUNSELOR) |
| Authorized Official Contact | 3174464125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonita Streetman, Llc 1445 Dominion Dr Zionsville IN 46077-1872 Ph: (317) 446-4125 | Bonita Streetman, Llc 2633 E 136th St Carmel IN 46032-1855 Ph: (317) 446-4125 |
| NPI Number | 1720524762 |
|---|---|
| Provider Enumeration Date | 01/14/2017 |
| Last Update Date | 01/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720524762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 34002619A (Indiana) | Primary |
| 251S00000X | Community/behavioral Health | 87000793A (Indiana) | Secondary |
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