Individual
MR. MICHAEL WILLIAM PETRIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.(R), ABD, LPC
Contact information
Practice address
331 MAIN ST, NORWICH, CT 06360-5836
(860) 889-8346
(860) 889-2658
Mailing address
331 MAIN ST, NORWICH, CT 06360-5836
(860) 889-8346
(860) 889-2658
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000430
CT
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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