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Individual
THEANNAH REMI LOUISE PHILLIPS
Active
Individual
THEANNAH REMI LOUISE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0903003190
VA
104100000X
Social Worker
Primary
DP00945849
WV
1041C0700X
Clinical Social Worker
0904017827
VA
1041C0700X
Clinical Social Worker
34106
MD
1041C0700X
Clinical Social Worker
Primary
DP00945849
WV
Other
Enumeration date
02/14/2022
Last updated
01/27/2026
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