Individual
MR. EARNEST RAY PHILLIPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
940 AVENUE 64, PASADENA, CA 91105
(323) 254-2274
(323) 254-9087
Mailing address
940 AVENUE 64, PASADENA, CA 91105
(323) 254-2274
(323) 254-9087
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
01/30/2009
Last updated
07/18/2013
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