Individual
KARDEQUA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 CAMERON ST, MONROE, LA 71201
(318) 651-9363
(318) 651-9251
Mailing address
103 GOLDIE ST APT A, FARMERVILLE, LA 71241-6609
(346) 774-6027
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/11/2017
Last updated
07/18/2019
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