Individual
CRYSTAL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
7777 BONHOMME AVE STE 1800, CLAYTON, MO 63105-1931
(636) 202-0693
(855) 568-2494
Mailing address
18726 S WESTERN AVE, GARDENA, CA 90248-3813
(310) 856-0800
(855) 568-2494
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MO
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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