Provider Demographics
NPI:1437626769
Name:STANLEY, REGINA LEIGH (LMFT)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:LEIGH
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:LEIGH
Other - Last Name:PONTBRIAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:522 W RIVERSIDE AVE STE N
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0580
Mailing Address - Country:US
Mailing Address - Phone:253-780-1239
Mailing Address - Fax:
Practice Address - Street 1:207 CENTER STREET
Practice Address - Street 2:
Practice Address - City:EATONVILLE
Practice Address - State:WA
Practice Address - Zip Code:98328
Practice Address - Country:US
Practice Address - Phone:253-780-1239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61131246106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist