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General NPI Number Information
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NPI Number | 1336866896
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Entity Type | Individual
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Provider Name | EMELDA R PHILLIP PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 8115 LESIA CIR
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City | ORLANDO
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State | FL
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Zip | 32835-5355
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Country | US
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Telephone | 973-609-0245
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Fax |
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Provider Business Mailing Address
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Address Line | 8115 LESIA CIR
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City | ORLANDO
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State | FL
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Zip | 32835-5355
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Country | US
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Telephone | 973-609-0245
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00895300
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License Number State | NJ
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