Individual
DESTINY GILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
542 HOPMEADOW ST STE 305, SIMSBURY, CT 06070-5405
(860) 428-3400
Mailing address
542 HOPMEADOW ST STE 305, SIMSBURY, CT 06070-5405
(860) 428-3400
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1608
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008049650
—
CT
Enumeration date
08/10/2010
Last updated
11/20/2019
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