Provider Demographics
NPI:1588719223
Name:CURTIS, REGINA DAVIS (D MIN)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:DAVIS
Last Name:CURTIS
Suffix:
Gender:F
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-7356
Mailing Address - Country:US
Mailing Address - Phone:434-685-3771
Mailing Address - Fax:434-791-4944
Practice Address - Street 1:625 PINEY FOREST RD
Practice Address - Street 2:SUITE 108
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2867
Practice Address - Country:US
Practice Address - Phone:434-791-2767
Practice Address - Fax:434-791-4944
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCU74420101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral