Individual
MR. GREGORY BRUCE JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
50 ACADEMY HILL ROAD, PLAINFIELD, CT 06374
(860) 564-3015
(860) 564-3025
Mailing address
50 ACADEMY HILL ROAD, P.O. BOX 201, PLAINFIELD, CT 06374
(860) 564-3015
(860) 564-3025
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000758
CT
Other
Enumeration date
10/03/2006
Last updated
11/14/2024
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