Individual
PENNY CHASTIL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 PLEASANT AVE, WELLSBURG, WV 26070-1344
(304) 737-3481
(304) 737-3480
Mailing address
1201 PLEASANT AVE, WELLSBURG, WV 26070-1344
(304) 737-3481
(304) 737-3480
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0748
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0152204000
—
WV
Enumeration date
12/20/2007
Last updated
12/20/2007
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