Individual
MICAH REGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5400 EUPER LN, FORT SMITH, AR 72903-3232
(870) 932-3600
Mailing address
5400 EUPER LN, FORT SMITH, AR 72903-3232
(870) 932-3600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
01/30/2018
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