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General NPI Number Information
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NPI Number | 1255762514
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Entity Type | Individual
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Provider Name | LATITIA PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1448 HOUSTON ST
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City | WILLS POINT
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State | TX
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Zip | 75169-3120
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Country | US
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Telephone | 903-873-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 342 CHAPEL HILL DR
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City | FORNEY
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State | TX
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Zip | 75126-3797
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Country | US
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Telephone | 903-407-0908
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 211962
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License Number State | TX
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