Individual
MRS. REGINA GAIL WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
763 YUKON ST NE, PALM BAY, FL 32907-3114
(321) 722-0476
(321) 722-0475
Mailing address
763 YUKON ST NE, PALM BAY, FL 32907-3114
(321) 722-0475
(321) 722-0475
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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