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Individual

MS. REGINA DELICIA WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EDD

Contact information

Practice address
3553B MEMORIAL DR, DECATUR, GA 30032-2711
(404) 289-6299
(404) 289-6298
Mailing address
4222 CHESTNUT LAKE AVE, LITHONIA, GA 30038-4568
(404) 456-6291

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LPC003980
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
834417259A
GA
Enumeration date
12/15/2006
Last updated
10/20/2008
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