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General NPI Number Information
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NPI Number | 1841155520
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Entity Type | Individual
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Provider Name | CHEYENNE SAMRA AHMAD
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Gender | Female
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 1 ELIOT PL FL 3
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City | FAIRFIELD
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State | CT
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Zip | 06824-5154
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Country | US
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Telephone | 203-307-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 335 CANNON DR
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City | STRATFORD
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State | CT
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Zip | 06614-2089
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3391
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License Number State | CT
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