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Individual

MRS. IRMA I PHILLIPS-MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAP

Contact information

Practice address
2002 NW 13TH ST, SUITE 120, GAINESVILLE, FL 32609-5414
(352) 376-1611
(352) 376-9482
Mailing address
PO BOX 1145, GAINESVILLE, FL 32602-1145
(352) 376-1611
(352) 376-9482

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CERTIFICATION #1979
FL

Other

Enumeration date
09/22/2006
Last updated
07/08/2007
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