| NPI | 1245285790 |
|---|---|
| Other Name | MARY REGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 171) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 2244) |
| 106H00000X Marriage & Family Therapist (Licence: LA 37) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |