Individual
MS. SUSAN P SIDWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
100 BANK STREET, SUITE 306, SEYMOUR, CT 06483
(203) 888-0462
(203) 888-1465
Mailing address
76 WESTBURY PARK ROAD, SUITE 303E, WATERBURY, CT 06795
(203) 525-2091
(860) 417-6099
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001484
CT
Other
Enumeration date
10/12/2011
Last updated
01/18/2012
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