Individual
NICOLE MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 581-1981
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 581-1981
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2021050704
MO
1041C0700X
Clinical Social Worker
Primary
2024018423
MO
Other
Enumeration date
04/22/2022
Last updated
06/13/2024
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