Provider Demographics
NPI:1972865723
Name:WATTIE, CARRIE BETH (MSED)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:BETH
Last Name:WATTIE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KERRY CT
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2341
Mailing Address - Country:US
Mailing Address - Phone:518-885-1746
Mailing Address - Fax:
Practice Address - Street 1:4 KERRY CT
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2341
Practice Address - Country:US
Practice Address - Phone:518-885-1746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist