Provider Demographics
NPI:1760096408
Name:REGIER, TINA D (LMSW, MSW U/S)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:D
Last Name:REGIER
Suffix:
Gender:F
Credentials:LMSW, MSW U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 N GRAND ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-3221
Mailing Address - Country:US
Mailing Address - Phone:580-234-3791
Mailing Address - Fax:580-237-7711
Practice Address - Street 1:702 N GRAND ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3221
Practice Address - Country:US
Practice Address - Phone:580-234-3791
Practice Address - Fax:580-237-7711
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program