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General NPI Number Information
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NPI Number | 1881784148
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Entity Type | Individual
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Provider Name | REGINA PYKE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 08/19/2009
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Provider Practice Location Address
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Address Line | 36 EAGLE ROW
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City | ATLANTA
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State | GA
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Zip | 30322-1000
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Country | US
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Telephone | 404-727-4139
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Fax | 404-727-1284
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Provider Business Mailing Address
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Address Line | 408 ADAMS ST
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City | DECATUR
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State | GA
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Zip | 30030-5208
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Country | US
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Telephone | 404-727-4139
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Fax | 404-727-1284
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 940
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License Number State | GA
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