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1275515009
MARK LESLIE GAYNOR
NEW HAVEN, CT
NPI
1275515009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CT 000930)
Enumeration Date
2005-11-17
Last Update Date
2018-06-27
Business Address
Mr. MARK LESLIE GAYNOR LCSW
100 WHITNEY AVE
NEW HAVEN, CT 06510
Phone number: 203-865-0865
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Mailing Address
Mr. MARK LESLIE GAYNOR LCSW
100 WHITNEY AVE
NEW HAVEN, CT 06510-1283
Phone number: 203-865-0865
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