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Individual

REGINALD DELOATCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4123 CEDAR SPRINGS ROAFD, APT. 2332, DALLAS, TX 75219
(214) 206-7100
Mailing address
PO BOX 1502, ADDISON, TX 75001-1502

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
373H00000X
Day Training/Habilitation Specialist

Other

Enumeration date
11/27/2018
Last updated
11/27/2018
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