Provider Demographics
NPI:1194931758
Name:KESHEN, MICHAL (MA, MSED, LMFT)
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:KESHEN
Suffix:
Gender:F
Credentials:MA, MSED, LMFT
Other - Prefix:MISS
Other - First Name:MICHAL
Other - Middle Name:F
Other - Last Name:KESHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MSED, LMFT
Mailing Address - Street 1:5825 SUNSET DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5222
Mailing Address - Country:US
Mailing Address - Phone:305-275-2056
Mailing Address - Fax:305-670-6203
Practice Address - Street 1:5825 SUNSET DR
Practice Address - Street 2:SUITE 301
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5222
Practice Address - Country:US
Practice Address - Phone:305-275-2056
Practice Address - Fax:305-670-6203
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist