Phillips, Faith Lucille

Phillips, Faith Lucille is an sole proprietor health care provider with primary practice located at 411 S. Park Drive , Broken Bow OK 74728. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Phillips, Faith Lucille can be contacted via phone (580) 584-5550.

Contact Information

Primary practice address
411 S. Park Drive Broken Bow OK 74728
Phone: (580) 584-5550
Fax: (866) 584-1223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 513 Oklahoma
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 513 Oklahoma

Profile Details

NPI number 1699925867
LBN Legal business name Phillips, Faith Lucille
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2008
Last updated Jul 25th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699925867 NPPES
Oklahoma MEDICAID 100837660A

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