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General NPI Number Information
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NPI Number | 1194509984
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Entity Type | Individual
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Provider Name | TAMARA GRAY-PHILLIPS MSMFT, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 145 LITTLE CONESTOGA RD
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-9562
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Country | US
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Telephone | 484-872-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 256 EAGLEVIEW BLVD STE 113
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City | EXTON
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State | PA
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Zip | 19341-1157
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Country | US
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Telephone | 484-872-2060
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | FT-0010085
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF001263
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License Number State | PA
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