Individual
DOLORES E PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 E MAIN STREET, 7TH FLOOR, TROTWOOD, OH 45426-4542
(937) 854-0210
Mailing address
1121 E MAIN ST FL 7, TROTWOOD, OH 45426-2411
(937) 854-0210
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326012360
—
OH
Enumeration date
01/19/2021
Last updated
01/19/2021
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