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General NPI Number Information
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NPI Number | 1144886797
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Entity Type | Individual
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Provider Name | KRISTIE PHILLIPS MS
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Gender | Female
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Dates
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Enumeration Date | 05/18/2019
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 265 S HARLAN ST
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City | LAKEWOOD
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State | CO
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Zip | 80226-2261
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Country | US
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Telephone | 720-272-1289
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Fax |
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Provider Business Mailing Address
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Address Line | 1338 CARTERET AVE
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City | PUEBLO
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State | CO
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Zip | 81004-3043
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Country | US
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Telephone | 719-600-1998
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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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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-82919
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License Number State | CO
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