Healthcare Provider Details
I. General information
NPI: 1588719223
Provider Name (Legal Business Name): REGINA DAVIS CURTIS D. MIN.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 PINEY FOREST RD SUITE 108
DANVILLE VA
24540-2867
US
IV. Provider business mailing address
440 WESTRIDGE DR
DANVILLE VA
24541-7356
US
V. Phone/Fax
- Phone: 434-791-2767
- Fax: 434-791-4944
- Phone: 434-685-3771
- Fax: 434-791-4944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | CU74420 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: