Provider Demographics
NPI:1336917293
Name:PHILLIPS, ANSLEY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANSLEY
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10579 CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-8376
Mailing Address - Country:US
Mailing Address - Phone:615-462-6233
Mailing Address - Fax:
Practice Address - Street 1:10579 CEDAR GROVE RD STE 120
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-8385
Practice Address - Country:US
Practice Address - Phone:615-462-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist