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Individual

DANIEL GRISWOLD GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
60 WATERBURY RD, HERITAGE PROFESSIONAL SUITE 2A, PROSPECT, CT 06712-1250
(203) 560-1158
(203) 757-8914
Mailing address
45 DEERWOOD LN # U3, WATERBURY, CT 06704-6114
(203) 754-2079
(203) 757-8914

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001060
CT

Other

Enumeration date
08/19/2006
Last updated
07/08/2007
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