Doctor Name: | MELANIE K PHILLIPS |
NPI Number: | 1073728812 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 405 East Excelsior Vinita, OK - 74301 |
Business Phone Number: | 9182566476 |
Business Fax Number: | 9182563628 |
Mailing Address: | P.o. Box 245, LANGLEY |
State: | OK |
Postal Code: | 74350 |
Phone Number: | 9186182117 |
Fax Number: | 9182563628 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |