Individual
MARIANKE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
326 DRIVEWAY ST STE 100, FAIRBANKS, AK 99701-2807
(907) 521-0890
Mailing address
PO BOX 74849, FAIRBANKS, AK 99707-4849
(907) 406-8813
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-70070
AK
Other
Enumeration date
11/08/2018
Last updated
01/23/2021
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