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NPI Code Detail

MEDICARE: REGINA HISE

MEDICARE: REGINA HISE
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1447587688
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA HISE
Provider Business Mailing Address
First Line : 116 NW 7TH ST
Second Line :
City : ANTLERS
State : OK
Zip : 74523-2225
Country : US
Telephone Number : 580-271-8309
Fax Number : 580-298-5072
Provider Business Practice Location Address
First Line : 608 HIGHWAY 271 N
Second Line :
City : ANTLERS
State : OK
Zip : 74523-2055
Country : US
Telephone Number : 580-298-5062
Fax Number : 580-298-5072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2009
Last Update Date : 11/09/2009

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Directions to “ REGINA HISE ” Practice Location

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