Doctor Name: | ROBERT WESLEY PHILLIPS |
NPI Number: | 1700152600 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LADAC, NCAC, SAP |
License Number: | LDC0000001023 |
Business Practice Address: | 217 Deer Point Rd Unionville, TN - 371802001 |
Business Phone Number: | 9312943409 |
Business Fax Number: | |
Mailing Address: | 217 Deer Point Rd, UNIONVILLE |
State: | TN |
Postal Code: | 371802001 |
Phone Number: | 9312943409 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2012 |
NPI Last Update Date: | 03/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LDC0000001023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |