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Individual

LESLIE NICOLE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1405 WEATHERLY PLZ SE STE E, HUNTSVILLE, AL 35803-2663
(256) 600-0574
Mailing address
415 N RICHARD JACKSON BLVD STE 202B, PANAMA CITY BEACH, FL 32407-3691
(850) 866-0441
(850) 710-0741

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/11/2020
Last updated
02/11/2020
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