Provider Demographics
NPI:1265474480
Name:COUNCIL, REGINA ELIZABETH (RT)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:ELIZABETH
Last Name:COUNCIL
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1416
Mailing Address - Country:US
Mailing Address - Phone:215-823-4448
Mailing Address - Fax:215-823-4027
Practice Address - Street 1:UNIVERSITY & WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-823-4448
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist