Provider Demographics
NPI:1508316423
Name:WARD, REGINA MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 OLD YORK RD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1539
Mailing Address - Country:US
Mailing Address - Phone:215-780-3169
Mailing Address - Fax:
Practice Address - Street 1:8380 OLD YORK RD
Practice Address - Street 2:SUITE 2100
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1539
Practice Address - Country:US
Practice Address - Phone:215-780-3169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002266L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist