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NPI Code Detail

MEDICARE: REGINA D GREENWOOD OT

MEDICARE: REGINA D GREENWOOD OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1366704769
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA D GREENWOOD OT
Provider Business Mailing Address
First Line : 130 DESIARD ST
Second Line : SUITE 355
City : MONROE
State : LA
Zip : 71201-7319
Country : US
Telephone Number : 318-807-7875
Fax Number : 318-812-9997
Provider Business Practice Location Address
First Line : 1825 N 18TH ST
Second Line : SUITE A
City : MONROE
State : LA
Zip : 71201-4420
Country : US
Telephone Number : 318-807-3700
Fax Number : 318-807-0014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2012
Last Update Date : 06/12/2012

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Directions to “ REGINA D GREENWOOD OT” Practice Location

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