Individual
TEEDI PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 19TH AVE SW, DECATUR, AL 35601-3756
(256) 654-9181
Mailing address
3224 SWEETBRIAR RD SW, DECATUR, AL 35603-3168
(256) 654-9181
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
01/05/2024
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