Phillips, Jacqueline

Phillips, Jacqueline is an individual health care provider with primary practice located at 6410 Fannin St Ste 1014 Attn: Director Of Neuropsychology, Houston TX 77030-5301. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Phillips, Jacqueline can be contacted via phone (713) 486-0503.

Contact Information

Primary practice address
6410 Fannin St Ste 1014 Attn: Director Of Neuropsychology Houston TX 77030-5301
Phone: (713) 486-0503
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PS017778 Pennsylvania

Profile Details

NPI number 1770670689
LBN Legal business name Phillips, Jacqueline
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Mar 4th, 2016 - about 10 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 1770670689 NPPES
Illinois Other 0533210001 DMERC
Illinois MEDICAID 2030728-01 DMERC

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