Individual
MACKENZIE FAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1372 SUMMER ST STE 300, STAMFORD, CT 06905-5361
(203) 859-9335
Mailing address
495 SHORE DR, BRANFORD, CT 06405-6230
(203) 414-2082
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5050
CT
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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