Individual
GERALD A FARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
140 GLASTONBURY BLVD, GLASTONBURY, CT 06033-4402
(860) 633-7501
(203) 248-1513
Mailing address
PO BOX 185417, HAMDEN, CT 06518-0417
(203) 248-1513
(203) 248-1513
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001277
CT
Other
Enumeration date
03/04/2007
Last updated
07/08/2007
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