Individual
STACEY L PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
185 BRONX RIVER RD, 4P, YONKERS, NY 10704-3752
(914) 888-6811
Mailing address
185 BRONX RIVER RD, 4P, YONKERS, NY 10704-3752
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2526005
NY
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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