Provider Demographics
NPI:1083929350
Name:MCELROY, REGINA BRUCETTE (SPEECH THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:BRUCETTE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 E LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-9171
Mailing Address - Country:US
Mailing Address - Phone:573-335-8031
Mailing Address - Fax:
Practice Address - Street 1:254 E LAKE DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-9171
Practice Address - Country:US
Practice Address - Phone:573-335-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist