Individual
GLORIA GREENIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6 BUSINESS PARK DR, SUITE 203A, BRANFORD, CT 06405-2988
(203) 506-5372
(203) 483-6400
Mailing address
3 HOMESIDE AVE, WEST HAVEN, CT 06516-2408
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
003498
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003498
STATE LICENSE
CT
Enumeration date
11/01/2006
Last updated
07/08/2007
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