| Doctor Name: | MRS. LISSETTE BAEZ |
| NPI Number: | 1013266634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 001912 |
| Business Practice Address: | 693 Bloomfield Ave Bloomfield, CT - 060022489 |
| Business Phone Number: | 8602436584 |
| Business Fax Number: | 8602436591 |
| Mailing Address: | 693 Bloomfield Ave, BLOOMFIELD |
| State: | CT |
| Postal Code: | 060022489 |
| Phone Number: | 8602436584 |
| Fax Number: | 8602436591 |
| NPI Enumeration Date: | 08/29/2012 |
| NPI Last Update Date: | 11/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |