Provider Demographics
NPI:1225535404
Name:HIGLEY, REGINA LOUISE
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:LOUISE
Last Name:HIGLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-2474
Mailing Address - Country:US
Mailing Address - Phone:775-463-6597
Mailing Address - Fax:775-463-6598
Practice Address - Street 1:720 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-2474
Practice Address - Country:US
Practice Address - Phone:775-463-6597
Practice Address - Fax:775-463-6598
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00657-P101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)