| Doctor Name: | JOHN T REGAN |
| NPI Number: | 1003965740 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYCHOLOGIST |
| License Number: | 6301002880 |
| Business Practice Address: | 420 W 5th Ave Flint, MI - 485032445 |
| Business Phone Number: | 8104965640 |
| Business Fax Number: | |
| Mailing Address: | 2400 Mckail Rd, BRUCE |
| State: | MI |
| Postal Code: | 480651015 |
| Phone Number: | 8107982389 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 6301002880 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |