Individual
REGINAH MBULA NGWILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3318 SPRING MEADOW LN, GRAND PRAIRIE, TX 75052-6482
(214) 900-6930
Mailing address
3318 SPRING MEADOW LN, GRAND PRAIRIE, TX 75052-6482
(214) 900-6930
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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