Individual
CLARISSA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9254 THREE CHOPT RD APT C, HENRICO, VA 23229-4049
(252) 578-8311
Mailing address
PO BOX 16097, RICHMOND, VA 23222-0297
(252) 578-8311
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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