Individual
GRETA E MACMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
149 DURHAM RD, MADISON, CT 06443-2677
(860) 966-9813
(203) 902-0191
Mailing address
101 NECK RD, MADISON, CT 06443-2814
(860) 966-9813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005959
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209589
—
CT
Enumeration date
10/19/2010
Last updated
03/22/2024
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