Individual
CHRISTINA M. GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 RETREAT AVE, HARTFORD HOSPITAL ANXIETY DISORDERS CENTER, HARTFORD, CT 06106-3309
(860) 545-7685
Mailing address
HARTFORD HOSPITAL PROFESSIONAL SERVICES, PO BOX 40,000 DEPT 634, HARTFORD, CT 06151-0001
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002880
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008028805
—
CT
Enumeration date
07/31/2008
Last updated
04/08/2010
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