Provider Demographics
NPI:1952989907
Name:PHILLIPS, BRITTANY L (LBS1)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:L
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LBS1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14252 N SOUTH SHORE DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-6205
Mailing Address - Country:US
Mailing Address - Phone:217-821-7087
Mailing Address - Fax:
Practice Address - Street 1:14252 N SOUTH SHORE DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-6205
Practice Address - Country:US
Practice Address - Phone:217-821-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist