Individual
REGINA RENEE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3841 IRISH SETTER DR, FORT WORTH, TX 76123-2596
(682) 414-0899
(817) 835-6753
Mailing address
3841 IRISH SETTER DR, FORT WORTH, TX 76123-2596
(682) 414-0899
(817) 835-6753
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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