Individual
MS. SAGE REGINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1533 S BOUVIER ST, PHILADELPHIA, PA 19146-4745
(267) 368-7114
Mailing address
1532 S BOUVIER ST, PHILADELPHIA, PA 19146-4746
(267) 368-7114
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF001155
PA
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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