Individual
MRS. JOANNA RENA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRSS
Contact information
Practice address
3144 SW 17TH ST, OKLAHOMA CITY, OK 73108-4245
(405) 922-6676
Mailing address
3144 SW 17TH ST, OKLAHOMA CITY, OK 73108-4245
(405) 922-6676
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
52145
OK
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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