| NPI | 1598159154 |
|---|---|
| Former Name | REGINA NICOLE CANTRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 80514) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2015-03-22 |
| Last Update Date | 2018-04-02 |