Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY4639 | FL |
N | 103G00000X | Clinical Psychologist | PY4639 | FL |
N | 103TC0700X | Clinical Psychologist | PY4639 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY4639 | FL |
N | 103TF0000X | Family Psychologist | PY4639 | FL |
NPI | 1083625263 |
---|---|
Provider Name | Dr. Eddy Regnier |
First Address | Sarasota, FL 34237-6023 |
Second Address | Sarasota, FL 34237-6023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18462 | CIGNA INSURANCE (01) | FL |
275685 | MHN INSURANCE (01) | FL |
73964 | BCBS INSURANCE (01) | FL |