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Organization
SHANDRA PHILLIPS
Active
Organization
SHANDRA PHILLIPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANDRA PHILLIPS (PROVIDER)
(904) 505-4972
Entity
Organization
Contact information
Practice address
205 SE 16TH AVE APT 19C, GAINESVILLE, FL 32601-8635
(352) 634-8068
Mailing address
814 SE 18TH TER, GAINESVILLE, FL 32641-9423
(352) 278-7651
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/19/2017
Last updated
04/18/2019
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