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General NPI Number Information
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NPI Number | 1477027068
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Entity Type | Individual
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Provider Name | REGINA MICHELLE SAULSBERRY MSW
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Gender | Female
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 2820 GRANT LINE RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-2494
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Country | US
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Telephone | 812-280-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 3407 CATHE DYKSTRA WAY UNIT 102
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City | LOUISVILLE
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State | KY
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Zip | 40216-3165
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Country | US
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Telephone | 502-296-0709
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 99090902A
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License Number State | IN
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