Individual
MS. REGINA COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
120 WAYLAND AVE, SUITE #6, PROVIDENCE, RI 02906-4318
(508) 954-2125
Mailing address
120 WAYLAND AVENUE, SUITE #6, PROVIDENCE, RI 02906
(508) 954-2125
(401) 851-1671
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MT00836
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT00836
MASSAGE THERAPIST
RI
Enumeration date
11/08/2016
Last updated
11/08/2016
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