Individual
AUDREY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 HALL ST, SUITE D, TRAVERSE CITY, MI 49684-2288
(231) 935-4163
Mailing address
105 HALL ST, SUITE D, TRAVERSE CITY, MI 49684-2288
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802088323
MI
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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