Individual
DIANE ELIZABETH PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1250 SE MAYNARD RD STE 204, CARY, NC 27511-6947
(919) 948-7718
Mailing address
6931 PIN OAK CT, CHARLOTTE, NC 28226-3962
(518) 859-8758
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C011765
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C011765
—
NC
Enumeration date
08/18/2020
Last updated
08/18/2020
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