Individual
MCKENZIE MARIANNE TAVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
45 SHERMAN ST, FAIRFIELD, CT 06824-5874
(203) 984-4838
Mailing address
45 SHERMAN ST, FAIRFIELD, CT 06824-5874
(203) 984-4838
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
46.004521
CT
101YP2500X
Professional Counselor
Primary
5452
CT
Other
Enumeration date
03/01/2022
Last updated
05/01/2026
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