Provider Demographics
NPI:1437477940
Name:BUCHANAN, REGINA MICHELLE (BA)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:MICHELLE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1609 GREENBRIAR PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7640
Mailing Address - Country:US
Mailing Address - Phone:405-753-3683
Mailing Address - Fax:405-735-3524
Practice Address - Street 1:1609 GREENBRIAR PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7640
Practice Address - Country:US
Practice Address - Phone:405-753-3683
Practice Address - Fax:405-735-3524
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health