Individual
REGINA MARIE NOWATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5239 NE HIGHLAND AVE, YACHATS, OR 97498-9009
(541) 265-4179
(541) 574-6252
Mailing address
5239 NE HIGHLAND AVE, YACHATS, OR 97498-9009
(541) 265-4179
(541) 574-6252
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L7531
OR
1041C0700X
Clinical Social Worker
Primary
L7531
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200537330A
—
KS
05
—
500735581
—
OR
Enumeration date
12/19/2007
Last updated
01/18/2022
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