Healthcare Provider Details

I. General information

NPI: 1225952047
Provider Name (Legal Business Name): REGINA A PRATER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 6TH AVE W
HUNTINGTON WV
25701-1716
US

IV. Provider business mailing address

10 6TH AVE W
HUNTINGTON WV
25701-1716
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-8014
  • Fax: 304-525-8014
Mailing address:
  • Phone: 304-525-8014
  • Fax: 304-525-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-504916
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: