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General NPI Number Information
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NPI Number | 1194664227
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Entity Type | Individual
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Provider Name | LARA ROSE PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 2522 VALLEYDALE RD STE 301
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City | HOOVER
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State | AL
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Zip | 35244-2703
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Country | US
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Telephone | 205-719-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 MAYFAIR PARK DR APT 202
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City | HOMEWOOD
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State | AL
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Zip | 35209-5629
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Country | US
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Telephone | 804-432-1462
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State | AL
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