Provider Demographics
NPI:1043402290
Name:FINLAYSON, REGINA HALE (OTRL CLT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:HALE
Last Name:FINLAYSON
Suffix:
Gender:F
Credentials:OTRL CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WALNUT STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901
Mailing Address - Country:US
Mailing Address - Phone:256-546-1431
Mailing Address - Fax:256-546-1433
Practice Address - Street 1:215 WALNUT STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901
Practice Address - Country:US
Practice Address - Phone:256-546-1431
Practice Address - Fax:256-546-1433
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1241225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532303OtherBLUE CROSS
ALQ59091Medicare UPIN