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Individual

BROOKE LILLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550
Mailing address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C00008
GRIFFIN HOSPITAL MEICARE #
CT
Enumeration date
12/31/2009
Last updated
04/15/2011
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