Doctor Name: | DAVID PHILLIPS |
NPI Number: | 1477951424 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 220 Hillcrest Dr Wellsburg, WV - 260701942 |
Business Phone Number: | 3042811178 |
Business Fax Number: | |
Mailing Address: | 220 Hillcrest Dr, WELLSBURG |
State: | WV |
Postal Code: | 260701942 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/08/2014 |
NPI Last Update Date: | 12/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |