Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1235530452 |
---|---|
Provider Name | Mrs. Regina Eagle |
First Address | Salisbury, NC 28144-2515 |
Second Address | Salisbury, NC 28144-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2014 |
Last Update Date | 08/09/2014 |