Individual
PHYLLIS J. RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
2336 GODDARD PKWY, EASTERN SHORE PSYCHOLOGICAL SERVICES, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACO251
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093074064
—
MD
05
—
705371101
—
MD
Enumeration date
12/27/2006
Last updated
08/30/2012
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