| Name | PETILLO DARREN JOSEPH |
|---|---|
| Address | STAMFORDCT |
| Profession | LICENSED CLINICAL SOCIAL WORK |
| License No | 052906 |
| Date of Licensure | 09/01/04 (OriginallylicensedasaCertifiedSocialWorkeron02/29/96) |
| Additional Qualification | R -Psychotherapy Privilege |
| Status | REGISTERED |
| Registered through last day of |