Individual
MR. RICKEY LYNN PHILLIPS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4400 SHUFFIELD DR, LITTLE ROCK, AR 72205-7100
(501) 686-9300
Mailing address
4400 SHUFFIELD DR, LITTLE ROCK, AR 72205-7100
(501) 686-9300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2187-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116378726
—
AR
Enumeration date
09/06/2006
Last updated
04/23/2008
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