Healthcare Provider Details

I. General information

NPI: 1013082528
Provider Name (Legal Business Name): THE PHILO CENTER FOR SENSORY BASED EVALUTAION AND TREATMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4066 SHELBURNE RD SUITE 8
SHELBURNE VT
05482-6905
US

IV. Provider business mailing address

4066 SHELBURNE RD SUITE 8
SHELBURNE VT
05482-6905
US

V. Phone/Fax

Practice location:
  • Phone: 802-985-8211
  • Fax: 802-985-8733
Mailing address:
  • Phone: 802-985-8211
  • Fax: 802-985-8733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateVT

VIII. Authorized Official

Name: MS. JILL L LYONS
Title or Position: DIRECTOR
Credential: OTR L
Phone: 802-985-8211