Individual
LISA MAUREEN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18434
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160584
UNITED HEALTHCARE
—
01
—
543042-04
BCBS OF MARYLAND
—
01
—
7914198
AETNA
—
01
—
T208
BLUECHOICE/GHMSI
—
Enumeration date
12/21/2006
Last updated
05/16/2008
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