Provider Demographics
NPI:1962173989
Name:SORMAZ, HEIDI (PHD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SORMAZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD TOWN HWY UNIT 6
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4529
Mailing Address - Country:US
Mailing Address - Phone:203-927-7604
Mailing Address - Fax:
Practice Address - Street 1:779 HIGH ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-4015
Practice Address - Country:US
Practice Address - Phone:713-502-6932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral