Provider Demographics
NPI:1518726397
Name:BAEHR-REED, LAETITIA JS (PSYD)
Entity Type:Individual
Prefix:
First Name:LAETITIA
Middle Name:JS
Last Name:BAEHR-REED
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SULLIVAN WAY
Mailing Address - Street 2:MARQUAND BUILDING SUITE 305
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2206
Mailing Address - Country:US
Mailing Address - Phone:808-778-3503
Mailing Address - Fax:
Practice Address - Street 1:100 SULLIVAN WAY
Practice Address - Street 2:MARQUAND BUILDING SUITE 305
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:609-633-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00596700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical