Individual
HOLLY REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12320 ASHLEY DR, STE D, GULFPORT, MS 39503-2550
(228) 282-3655
Mailing address
12320 ASHLEY DR, STE D, GULFPORT, MS 39503-2550
(228) 282-3655
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C7870
MS
Other
Enumeration date
03/05/2015
Last updated
10/28/2016
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