Individual
MISS CRYSTAL I PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2921 E 91ST, TULSA, OK 74137
(918) 298-5059
Mailing address
1619 S 108TH E AVE, TULSA, OK 74128
(206) 227-0840
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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