Provider Demographics
NPI:1891024162
Name:REGAN, LOUISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:REGAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIE LOUISE
Other - Middle Name:
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:549 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:549 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1020
Practice Address - Country:US
Practice Address - Phone:610-358-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011049225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist