Provider Demographics
NPI:1336589910
Name:SARGENT, REGINALD MAURICE II
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:MAURICE
Last Name:SARGENT
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 RUBY LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-4000
Mailing Address - Country:US
Mailing Address - Phone:702-769-8220
Mailing Address - Fax:
Practice Address - Street 1:1838 RUBY LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-4000
Practice Address - Country:US
Practice Address - Phone:702-769-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst