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Individual
PHILLIP CARR
Active
Individual
PHILLIP CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SC60189451
WA
1041C0700X
Clinical Social Worker
Primary
LW60494715
WA
Other
Enumeration date
03/25/2011
Last updated
10/21/2021
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