Individual
SHANICKA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 5TH ST, STAMFORD, CT 06905-5012
(203) 323-8160
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
78848
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2022
Last updated
07/03/2024
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