Healthcare Provider Details

I. General information

NPI: 1225682297
Provider Name (Legal Business Name): REGINA BILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 E HIGHLAND AVE STE 205
PHOENIX AZ
85016-4834
US

IV. Provider business mailing address

19635 N CAVE CREEK RD APT 366
PHOENIX AZ
85024-1880
US

V. Phone/Fax

Practice location:
  • Phone: 480-559-9104
  • Fax:
Mailing address:
  • Phone: 602-777-0364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC21204
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: