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Individual

MS. REGINA WENSIL BEAMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-4310
Mailing address
4100 HILTON LAKE RD, KANNAPOLIS, NC 28083-9643
(704) 932-7785

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0630
NC

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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