Individual
MISS ARDISSA LIANDA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
530 STANLEY AVE, P.S. K4/ DISTRICT 75, BROOKLYN, NY 11207-7714
(718) 498-6680
Mailing address
530 STANLEY AVE, P.S. K4/ DISTRICT 75, BROOKLYN, NY 11207-7714
(718) 498-6680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
63015885
NY
Other
Enumeration date
10/24/2012
Last updated
09/28/2013
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