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Individual

REGINA FAY LOVELESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2403 BATTLEFIELD PKWY, FORT OGLETHROPE, GA 30742
(706) 866-7700
Mailing address
66 ARMSTRONG ROAD, LAFAYETTE, GA 30728
(423) 755-1029

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA0000002729
TN
224Z00000X
Occupational Therapy Assistant
Primary
OTA002130
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
224Z00000X
GA
Enumeration date
05/15/2017
Last updated
05/15/2017
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