Individual
DR. RANDALL WALLACE PHILLIPS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
367B N PARKWAY, JACKSON, TN 38305-2865
(731) 668-2277
Mailing address
26 CHANDLERS CV, JACKSON, TN 38305-6913
(731) 660-6015
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT 000050
TN
Other
Enumeration date
08/12/2005
Last updated
07/08/2007
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