Provider Demographics
NPI:1609061472
Name:REGAZZI, AMRAH MYERS (MSW)
Entity Type:Individual
Prefix:
First Name:AMRAH
Middle Name:MYERS
Last Name:REGAZZI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 WILLOW RUN RD APT 1B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-0120
Mailing Address - Country:US
Mailing Address - Phone:803-979-4191
Mailing Address - Fax:
Practice Address - Street 1:2815 COLISEUM CENTRE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1452
Practice Address - Country:US
Practice Address - Phone:704-357-7920
Practice Address - Fax:704-357-7921
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health