Individual
MRS. LISA MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2710 12 MILE RD, BERKLEY, MI 48072-1630
(248) 543-1090
(248) 543-0017
Mailing address
19814 DELAWARE AVE, REDFORD, MI 48240-1516
(313) 543-7760
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1705289
—
MI
Enumeration date
11/29/2006
Last updated
07/09/2007
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