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General NPI Number Information
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NPI Number | 1275364093
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Entity Type | Individual
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Provider Name | REAGAN ELIZABETH DOAK
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Gender | Female
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Dates
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Enumeration Date | 08/13/2024
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 10 6TH AVE W
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City | HUNTINGTON
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State | WV
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Zip | 25701-0028
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Country | US
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Telephone | 304-525-8014
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Fax | 304-525-8026
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Provider Business Mailing Address
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Address Line | 24 LEE RD
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City | HUNTINGTON
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State | WV
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Zip | 25704-9266
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Country | US
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Telephone | 304-633-6535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | RBT-24-392033
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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