Individual
ALECIA DIEDRE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8617 E COLONIAL DR STE 1100, ORLANDO, FL 32817-3919
(407) 895-0801
(407) 930-2569
Mailing address
2975 GRANDEVILLE CIR APT 217, OVIEDO, FL 32765-6083
(862) 210-0203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-37144
NJ
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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