Provider Demographics
NPI:1235908252
Name:LAWTON, REGINA ANNETTE
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:ANNETTE
Last Name:LAWTON
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 1:778 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3032
Mailing Address - Country:US
Mailing Address - Phone:810-247-0548
Mailing Address - Fax:810-270-2323
Practice Address - Street 1:814 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3073
Practice Address - Country:US
Practice Address - Phone:810-660-8275
Practice Address - Fax:810-270-2323
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling