Provider Demographics
NPI:1821475310
Name:SPAAY, REGINA CLAIRE (PT)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:CLAIRE
Last Name:SPAAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641-0703
Mailing Address - Country:US
Mailing Address - Phone:970-220-2245
Mailing Address - Fax:
Practice Address - Street 1:542 16TH ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5241
Practice Address - Country:US
Practice Address - Phone:307-324-2759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1417172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker