Individual
REGINA HISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
608 HIGHWAY 271 N, ANTLERS, OK 74523-2055
(580) 298-5062
(580) 298-5072
Mailing address
116 NW 7TH ST, ANTLERS, OK 74523-2225
(580) 271-8309
(580) 298-5072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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