Provider Demographics
NPI:1013280981
Name:BREMAN, REGINA MADISON (SOCIAL WORKER,BSW)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MADISON
Last Name:BREMAN
Suffix:
Gender:F
Credentials:SOCIAL WORKER,BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33250 WARREN RD STE 17
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2920
Mailing Address - Country:US
Mailing Address - Phone:734-266-9340
Mailing Address - Fax:734-266-9350
Practice Address - Street 1:33250 WARREN RD STE 17
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2920
Practice Address - Country:US
Practice Address - Phone:734-266-9340
Practice Address - Fax:734-266-9350
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency