Stacey Leann Phillips
Day Training/Habilitation Specialist in McMechen, WV. Individual provider (NPI-1).
NPI number1699400952
StatusActive
Last updated in NPPESJul 20, 2022
Details
- NPI
- 1699400952
- Entity type
- Individual (NPI-1)
- Name
- Miss Stacey Leann Phillips
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 20, 2022
- Certification date
- Jul 20, 2022
- Last updated
- Jul 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
Practice location
19 16th StMcMechen, WV 26040-1321
Phone 304-517-6481
Mailing address
19 16th StMcMechen, WV 26040-1321
Phone 304-517-6481
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