Individual
ELIZABETH CHEYENNE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
634 N MAIN ST STE 4, O FALLON, IL 62269-3746
(618) 726-5870
Mailing address
996 ROYAL MARCO WAY, MARCO ISLAND, FL 34145-1829
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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