Individual
DR. CORY BRIDWELL SELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
176 AMITY RD, WOODBRIDGE, CT 06525-2239
(203) 736-2601
Mailing address
176 AMITY RD # 232, WOODBRIDGE, CT 06525-2239
(203) 232-0716
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002595
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00235918
—
CT
01
—
11751794
CAQH
CT
Enumeration date
03/10/2006
Last updated
03/07/2022
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