Provider Demographics
NPI:1124755160
Name:TASHANGANG, REGINE NKAMLOUNG
Entity type:Individual
Prefix:
First Name:REGINE
Middle Name:NKAMLOUNG
Last Name:TASHANGANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3423
Mailing Address - Country:US
Mailing Address - Phone:978-516-8636
Mailing Address - Fax:
Practice Address - Street 1:8 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3423
Practice Address - Country:US
Practice Address - Phone:978-516-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service