Individual
DR. CARLY JAYNE BUELTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
820 N ORLEANS ST STE 350, CHICAGO, IL 60610-3145
(312) 809-0298
Mailing address
820 N ORLEANS ST STE 350, CHICAGO, IL 60610-3145
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
071.010677
IL
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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