Individual
MARTHA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3610 W VILLAGE TER, SPRINGFIELD, MO 65810-1027
(417) 882-9343
Mailing address
3610 W VILLAGE TER, SPRINGFIELD, MO 65810-1027
(417) 882-9343
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002172
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495363517
—
MO
Enumeration date
08/02/2005
Last updated
12/01/2010
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