Individual
KEITH MICHAELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 KINGS HWY STE 206, FAIRFIELD, CT 06824-5321
(203) 216-4742
Mailing address
1525 KINGS HWY STE 206, FAIRFIELD, CT 06824-5321
(203) 216-4742
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1985
CT
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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