Gourdine, I Regina

Gourdine, I Regina is an sole proprietor health care provider with primary practice located at 9378 Olive Blvd Ste 311 , Saint Louis MO 63132-3224. She recently has 4 registered licenses in different health care specialties including Nursing Service Related Providers / Home Health Aide, Nursing Service Related Providers / Homemaker, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Gourdine, I Regina can be contacted via phone (314) 845-3502.

Contact Information

Primary practice address
9378 Olive Blvd Ste 311 Saint Louis MO 63132-3224
Phone: (314) 845-3502
Fax: (314) 329-6858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Home Health Aide 374U00000X Missouri
Nursing Service Related Providers / Homemaker 376J00000X Missouri
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 004214 Missouri

Profile Details

NPI number 1396873089
LBN Legal business name Gourdine, I Regina
Credentials MSW , LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 2nd, 2007
Last updated Jul 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396873089 NPPES
Missouri MEDICAID 493656805

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