Provider Demographics
NPI:1477127124
Name:PHILLIPS FERDINANDO, WILMA
Entity Type:Individual
Prefix:MS
First Name:WILMA
Middle Name:
Last Name:PHILLIPS FERDINANDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 VINE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1031
Mailing Address - Country:US
Mailing Address - Phone:267-507-6758
Mailing Address - Fax:
Practice Address - Street 1:1427 VINE ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1031
Practice Address - Country:US
Practice Address - Phone:267-507-6758
Practice Address - Fax:215-762-2531
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker