Individual
RANDI PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
181 W REYNOLDS ST, OZARK, AL 36360-1438
(334) 477-4686
Mailing address
512 E MCKINNON ST, NEW BROCKTON, AL 36351-6608
(334) 406-4079
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21164911
AL
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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