Healthcare Provider Details

I. General information

NPI: 1952211211
Provider Name (Legal Business Name): REGINA BURR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 OAKFIELD DR STE 205
BRANDON FL
33511-0827
US

IV. Provider business mailing address

1602 OAKFIELD DR STE 205
BRANDON FL
33511-0827
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-6367
  • Fax: 813-409-2915
Mailing address:
  • Phone: 813-655-6367
  • Fax: 813-409-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: