Individual
KYLE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7120 S 29TH ST, LINCOLN, NE 68516-5802
(402) 259-6948
Mailing address
PO BOX 736707, CHICAGO, IL 60673-6707
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-443583
NE
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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