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Individual

STEPHANIE GILL-MANVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
21 MONTAUK AVENE, NEW LONDON, CT 06320-6397
(860) 271-4700
(860) 271-4797
Mailing address
PO BOX 390, NEW LONDON, CT 06320-0390
(860) 271-4700
(860) 271-4797

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001752
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004253027
CT
Enumeration date
10/10/2008
Last updated
03/03/2016
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