MEDICARE: JASMIN PHILLIPS MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1023522679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMIN PHILLIPS MOT, OTR/L

Provider Business Mailing Address
First Line	:	9439 PALLADIUM HTS UNIT D203
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1548
Country	:	US
Telephone Number	:	330-219-3179
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 SANCTUARY DR
Second Line	:
City	:	CORTLAND
State	:	OH
Zip	:	44410-8816
Country	:	US
Telephone Number	:	330-219-3179
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2017
Last Update Date	:	05/22/2026

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Directions to “ JASMIN PHILLIPS MOT, OTR/L” Practice Location

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