MEDICARE: LAMARIANA PHILLIPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		IA

General Provider Information

NPI Number	:	1518816529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMARIANA PHILLIPS

Provider Business Mailing Address
First Line	:	309 E CENTRAL PARK AVE APT 311
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52803-1823
Country	:	US
Telephone Number	:	563-639-8137
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 W KIMBERLY RD STE 46
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52806-5717
Country	:	US
Telephone Number	:	515-207-5251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “ LAMARIANA PHILLIPS ” Practice Location

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