Organization
DR. SUSAN P. PHILLIPS, PH.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN P PHILLIPS PH.D. (PSYCHOLOGIST)
(813) 997-4538
Entity
Organization
Contact information
Practice address
2824 WINDGUARD CIR, SUITE 102, WESLEY CHAPEL, FL 33544-7369
(813) 997-4538
(813) 991-7584
Mailing address
2824 WINDGUARD CIR, SUITE 102, WESLEY CHAPEL, FL 33544-7369
(813) 997-4538
(813) 991-7584
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY7291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HD093A
MEDICARE PTAN
FL
Enumeration date
08/12/2014
Last updated
03/03/2015
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