Individual
AMANDA MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4220 N 20TH AVE, PHOENIX, AZ 85015-5124
(602) 889-9401
Mailing address
521 S 3RD ST, PHOENIX, AZ 85004-2757
(602) 603-1538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-17627
AZ
Other
Enumeration date
01/05/2019
Last updated
01/29/2019
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