Provider Demographics
NPI:1649838350
Name:REGALADO, ANNABELLE MARGARITA (PSYD)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:MARGARITA
Last Name:REGALADO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11007 WESTPORT STATION DR
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2761
Mailing Address - Country:US
Mailing Address - Phone:314-323-1015
Mailing Address - Fax:
Practice Address - Street 1:386 STANLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-6009
Practice Address - Country:US
Practice Address - Phone:508-324-3550
Practice Address - Fax:508-676-5671
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023017912103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist