Provider Information for 1356522189
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REGINA PATE-TERRY LCSW.LAC
Sex: Female
NPI: 1356522189
Last Updated: 2012-03-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1356522189 | ||||||||||||
| Enumeration Date | 2007-11-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3475 MONROE AVE SUITE 103 BUTTE, MT 59701-3869 United States Phone: 406-494-2130 | Fax: | ||||||||||||
| Primary Practice Address | 3475 MONROE AVE SUITE 103 BUTTE, MT 59701-3869 United States Phone: 406-494-2130 | Fax: | ||||||||||||
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