Provider Demographics
NPI:1942897418
Name:HARKLEROAD, REGINA (MS, BSL)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:HARKLEROAD
Suffix:
Gender:F
Credentials:MS, BSL
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BSL
Mailing Address - Street 1:100 EMERSON LN STE 1525
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-3484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 EMERSON LN STE 1525
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-3484
Practice Address - Country:US
Practice Address - Phone:412-660-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABHOO3212106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst