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General NPI Number Information
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NPI Number | 1780087916
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Entity Type | Individual
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Provider Name | KATHLEEN PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 711 FESS STREET
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City | ZANESVILLE
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State | OH
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Zip | 43701
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Country | US
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Telephone | 740-453-0575
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 FRIENDSHIP DR
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City | NEW CONCORD
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State | OH
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Zip | 43762-1025
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Country | US
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Telephone | 740-607-9062
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP. 11263
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License Number State | OH
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