Provider Demographics
NPI:1558753897
Name:SIRRY, DONALD RAY
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RAY
Last Name:SIRRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BUSINESS PARK DRIVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-433-0299
Mailing Address - Fax:203-643-2042
Practice Address - Street 1:9 BUSINESS PARK DRIVE
Practice Address - Street 2:UNIT 1
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-433-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical