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General NPI Number Information
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NPI Number | 1689658916
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Entity Type | Individual
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Provider Name | REGINA MAE LEFAUVE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 19772 ONE NORMAN BLVD
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City | CORNELIUS
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State | NC
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Zip | 28031
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Country | US
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Telephone | 980-306-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 514 WILLIAMSON RD SUITE 431
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City | MOORESVILLE
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State | NC
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Zip | 28117-9225
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Country | US
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Telephone | 704-641-4461
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Fax | 704-896-2686
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5366
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License Number State | NC
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