Individual
REGAN PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1229 38TH AVE N # 391, MYRTLE BEACH, SC 29577-1313
(185) 583-2672
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/26/2024
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