Individual
REGINA EASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4446 E JOEY AVE, FLAGSTAFF, AZ 86004-2415
(928) 221-9632
Mailing address
4446 E JOEY AVE, FLAGSTAFF, AZ 86004-2415
(928) 221-9632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-005556
AZ
Other
Enumeration date
02/22/2013
Last updated
11/04/2019
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