Organization
PSYCHOLOGY PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD K. PHILLIPS M.A. (OWNER)
(269) 277-6657
Entity
Organization
Contact information
Practice address
2519 NILES AVE, SAINT JOSEPH, MI 49085-1936
(269) 277-6657
Mailing address
2519 NILES AVE, SAINT JOSEPH, MI 49085-1936
(269) 277-6657
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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