Individual
CARLY BAETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
JD, PHD
Contact information
Practice address
10 NATHAN D PERLMAN PL, NEW YORK, NY 10003-3851
(917) 409-8989
Mailing address
443 17TH ST, APT 2L, BROOKLYN, NY 11215-6233
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021885
NY
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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