Individual
DR. SHIVA REZVAN HOMAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1095 S MAIN ST, CHESHIRE, CT 06410-3432
(203) 271-3809
Mailing address
1095 S MAIN ST, CHESHIRE, CT 06410-3432
(570) 472-5088
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003650
CT
Other
Enumeration date
11/19/2017
Last updated
06/26/2018
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