Individual
DR. REGINALD NETTLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6217 IRONWOOD WAY, COLUMBIA, MD 21045-4466
(410) 290-7999
(443) 583-2353
Mailing address
6217 IRONWOOD WAY, COLUMBIA, MD 21045-4466
(410) 290-7999
(443) 583-2353
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
02642
MD
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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