Individual
CORISSA PHANNENSTILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
2075 RALPH STEPHENS RD, HOLLY SPRINGS, NC 27540-8881
(704) 780-4271
Mailing address
2075 RALPH STEPHENS RD, HOLLY SPRINGS, NC 27540-8881
(704) 780-4271
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/30/2025
Last updated
09/30/2025
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