Provider Demographics
NPI:1023403375
Name:KWENDI, REGINA
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:KWENDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23802 TUSCANY PLZ
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-4048
Mailing Address - Country:US
Mailing Address - Phone:405-922-4228
Mailing Address - Fax:405-271-3199
Practice Address - Street 1:23802 TUSCANY PLAZA
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025
Practice Address - Country:US
Practice Address - Phone:405-922-4228
Practice Address - Fax:405-271-3199
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health