Provider Demographics
NPI:1174170799
Name:SCULL, REGINA EVE (MSW/MBA)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:EVE
Last Name:SCULL
Suffix:
Gender:F
Credentials:MSW/MBA
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:EVE
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 PURPLE CANYON DR SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-6356
Mailing Address - Country:US
Mailing Address - Phone:505-507-8941
Mailing Address - Fax:
Practice Address - Street 1:2551 COORS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1213
Practice Address - Country:US
Practice Address - Phone:505-883-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor