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Individual

DOROTHY MARIE PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
919 MITCHELL AVE, CHINA GROVE, NC 28023-7418
(330) 704-8591
Mailing address
919 MITCHELL AVE, CHINA GROVE, NC 28023-7418
(330) 506-5252

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
164W00000X
Licensed Practical Nurse
Primary
76732
NC

Other

Enumeration date
03/02/2022
Last updated
12/09/2022
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