Provider Demographics
NPI:1003082959
Name:QUIGLEY, REGINA A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6854 MAGNOLIA POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-3538
Mailing Address - Country:US
Mailing Address - Phone:407-294-3360
Mailing Address - Fax:
Practice Address - Street 1:10125 W COLONIAL DR
Practice Address - Street 2:SUITE 216
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4211
Practice Address - Country:US
Practice Address - Phone:407-295-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8634235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist