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Individual

CLARA ANNETTE PHILLIPPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2001 COOPER RD, PICAYUNE, MS 39466
(769) 242-2772
Mailing address
251 LUMPKIN RD, CARRIERE, MS 39426
(845) 820-0110

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
323871
CO
224Z00000X
Occupational Therapy Assistant
Primary
OTA-4038

Other

Enumeration date
03/11/2014
Last updated
01/15/2026
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