| Doctor Name: | MS. REGINA L. PURYEAR |
| NPI Number: | 1104962430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 3718 |
| Business Practice Address: | Lurline Smith Mhc 900 Wilkinson St. Mandeville, LA - 70448 |
| Business Phone Number: | 9856244450 |
| Business Fax Number: | 9856244461 |
| Mailing Address: | Lurline Smith Mhc, 900 Wilkinson St. MANDEVILLE |
| State: | LA |
| Postal Code: | 70448 |
| Phone Number: | 9856244450 |
| Fax Number: | 9856244461 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 3718 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |