Provider Demographics
NPI:1184828501
Name:MICHIE, DANA (LMFT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:MICHIE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 APPLE LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-2806
Mailing Address - Country:US
Mailing Address - Phone:203-544-8122
Mailing Address - Fax:203-544-8122
Practice Address - Street 1:436 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2023
Practice Address - Country:US
Practice Address - Phone:203-834-5020
Practice Address - Fax:203-563-9936
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001014106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist