Individual
MRS. PHYLLIS LEE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
187 N MAIN ST, WALLINGFORD, CT 06492-3721
(203) 269-1300
Mailing address
61 CLIFFSIDE DR, WALLINGFORD, CT 06492-1923
(203) 269-5094
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000908
CT
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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