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Individual

MRS. KATIE MARIE PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
2339 LAKE PARK DR, ALBANY, GA 31707-3360
(229) 553-0992
(229) 638-6302
Mailing address
2339 LAKE PARK DR, ALBANY, GA 31707-3360
(229) 255-3099
(229) 638-6302

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
208144244
208144244
GA
Enumeration date
01/10/2011
Last updated
12/30/2019
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