Provider Demographics
NPI:1073823084
Name:CANSLER, REGINA GALE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:GALE
Last Name:CANSLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 TALAVERA PKWY
Mailing Address - Street 2:APT. 1017
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1055
Mailing Address - Country:US
Mailing Address - Phone:254-519-1144
Mailing Address - Fax:254-519-1155
Practice Address - Street 1:1010 W JASPER DR
Practice Address - Street 2:SUITE 9
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1331
Practice Address - Country:US
Practice Address - Phone:254-519-1144
Practice Address - Fax:254-519-1155
Is Sole Proprietor?:No
Enumeration Date:2010-10-12
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3512OtherMEDICARE GROUP NUMBER