Provider Demographics
NPI:1962217653
Name:SCALES, REGINA MONIQUE
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:MONIQUE
Last Name:SCALES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 TIMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3124
Mailing Address - Country:US
Mailing Address - Phone:901-264-2155
Mailing Address - Fax:
Practice Address - Street 1:4009 TIMBERWOOD DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3124
Practice Address - Country:US
Practice Address - Phone:901-643-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty