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General NPI Number Information
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NPI Number | 1124615794
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Entity Type | Individual
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Provider Name | TAMIA PHILLIPS RBT
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 10/08/2023
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Provider Practice Location Address
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Address Line | 3408 S ATLANTIC AVE
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City | DAYTONA BEACH SHORES
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State | FL
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Zip | 32118-6311
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Country | US
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Telephone | 386-767-3752
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 SKYLINE LOOP APT 101
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City | ORANGE CITY
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State | FL
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Zip | 32763-8047
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Country | US
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Telephone | 407-406-4587
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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