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Individual
STACY J PHILLIPS
Active
Individual
STACY J PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015323-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00357240
—
NY
Enumeration date
09/25/2008
Last updated
09/26/2018
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