Provider Demographics
NPI:1215964515
Name:BRUNO, REGINA L (MSW LISW S)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:L
Last Name:BRUNO
Suffix:
Gender:
Credentials:MSW LISW S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26499 TARLTON ADELPHI RD
Mailing Address - Street 2:
Mailing Address - City:LAURELVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43135-9719
Mailing Address - Country:US
Mailing Address - Phone:740-248-8492
Mailing Address - Fax:
Practice Address - Street 1:26499 TARLTON ADELPHI RD
Practice Address - Street 2:
Practice Address - City:LAURELVILLE
Practice Address - State:OH
Practice Address - Zip Code:43135-9719
Practice Address - Country:US
Practice Address - Phone:740-248-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0600149 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical