Provider Demographics
NPI:1225589716
Name:REGINO, GABRIELA (NMD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:REGINO
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 E RAINTREE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7308
Mailing Address - Country:US
Mailing Address - Phone:480-657-0003
Mailing Address - Fax:
Practice Address - Street 1:9200 E RAINTREE DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7308
Practice Address - Country:US
Practice Address - Phone:480-657-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1576175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath