Individual
MS. MARY JOHNSON PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1117 WILLOUGHBY AVE, APT. 3R, BROOKLYN, NY 11237-2745
(917) 929-3755
Mailing address
1117 WILLOUGHBY AVE, APT. 3R, BROOKLYN, NY 11237-2745
(917) 929-3577
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
7631759
AL
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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