Individual
MYRANDA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 W STONES CROSSING RD STE 120, GREENWOOD, IN 46143-8558
(317) 528-2018
(317) 528-2907
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007004A
IN
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
11/08/2019
Last updated
08/21/2023
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