Most Relevant Information
Provider Data
| NPI Number: | 1003511973 |
| Provider Name: | KELY MCCONNELL REGAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/31/2023 |
| Last Updated: | 03/31/2023 |
Provider Practice Location
94166 8TH ST
GOLD BEACH
OR
974447747
Practice Location Phone/Fax
| Phone: | 5414255502 |
| Fax: |
Provider Mailing Location
PO BOX 1845
GOLD BEACH
OR
974441845
Provider Mailing Phone/Fax
| Phone: | 5414255502 |
| Fax: |