Individual
DIANNE S PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2022 WRIGHTSVILLE AVE, WILMINGTON, NC 28403-4112
(910) 763-3773
Mailing address
405 STRADA ST, WILMINGTON, NC 28409-5938
(910) 794-7138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3656
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103583
—
NC
Enumeration date
05/22/2007
Last updated
02/26/2008
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