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1124774096
MCKENZIE MARIANNE TAVELLA
FAIRFIELD, CT
NPI
1124774096
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: CT 46.004521)
Enumeration Date
2022-03-01
Last Update Date
2022-03-01
Business Address
MCKENZIE MARIANNE TAVELLA LPC-A
125 PENFIELD RD
FAIRFIELD, CT 06824-6611
Phone number: 203-255-5777
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Mailing Address
MCKENZIE MARIANNE TAVELLA LPC-A
475 CLINTON AVE
BRIDGEPORT, CT 06605-1700
Phone number: 203-255-5777
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