Individual
LARISA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1335 N 5TH STREET EXT, SUITE B, CORDELE, GA 31015-3753
(229) 273-2091
(229) 273-2022
Mailing address
415 N JACKSON ST, AMERICUS, GA 31709-3015
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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