Individual
CARLY BOSACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
124 W 79TH ST APT 1B, NEW YORK, NY 10024-6488
(763) 234-7825
Mailing address
93 1ST PL, APT 3F, BROOKLYN, NY 11231-3497
(763) 234-7825
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
982912738
NY
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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