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Individual

MR. JEFFREY P PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
505 W 15TH, PLEASANTON, KS 66075-4095
(912) 352-8214
(913) 352-8236
Mailing address
PO BOX 807, 304 N JEFFERSON AVE, IOL, KS 66749-2324
(620) 365-8641
(620) 365-8642

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1427
KS

Other

Enumeration date
10/05/2011
Last updated
07/11/2012
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