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Individual

AMANDA B PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1314 N LIBERTY CIR W, GREENSBURG, IN 47240-6647
(812) 663-2273
(812) 663-2275
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
(765) 450-6453

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1118292
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300010163
IN
Enumeration date
12/22/2011
Last updated
08/08/2019
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