Individual
RHONDA MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
609 REDWATER RD., WAKE VILLAGE, TX 75501
(903) 501-8032
Mailing address
PO BOX 7712, SHREVEPORT, LA 71137-7712
(318) 773-3520
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
834685225
—
TX
Enumeration date
02/09/2022
Last updated
02/09/2022
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