Provider Demographics
NPI:1578799243
Name:MCCARY, REGINA TERESA (MED)
Entity Type:Individual
Prefix:MISS
First Name:REGINA
Middle Name:TERESA
Last Name:MCCARY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13931 SPOONBILL ST N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1388
Mailing Address - Country:US
Mailing Address - Phone:904-379-9706
Mailing Address - Fax:
Practice Address - Street 1:13931 SPOONBILL ST N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1388
Practice Address - Country:US
Practice Address - Phone:904-379-9706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist