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Individual

MS. DORA DIANE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3033 N WALNUT AVE, OKLAHOMA CITY, OK 73105-2832
(405) 230-1163
Mailing address
4224 NW 14TH ST, OKLAHOMA CITY, OK 73107-4206
(405) 889-1886

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
10/06/2008
Last updated
10/06/2008
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