Jerome Latray Phillips
Rehabilitation Psychologist
5400 Willow Cliff Rd Apt 436
Oklahoma City
, Oklahoma 73122-6341
Jerome Latray Phillips
Rehabilitation Psychologist
5400 Willow Cliff Rd Apt 436
Oklahoma City
, Oklahoma 73122-6341
(405) 789-0168
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Jerome Latray Phillips
- 5400 Willow Cliff Rd Apt 436
- Oklahoma City, OK
- Zip : 73122-6341
- Phone : (405) 789-0168
Second Address
- Jerome Latray Phillips
- 5400 Willow Cliff Rd Apt 436
- Oklahoma City, OK
- Zip : 73122-6341
- Phone : (405) 789-0168
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist | S082659956 | OK |
National Provider Identifier
| NPI | 1457634511 |
|---|---|
| Provider Name | Jerome Latray Phillips |
| First Address | Oklahoma City, OK 73122-6341 |
| Second Address | Oklahoma City, OK 73122-6341 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/09/2011 |
| Last Update Date | 26/09/2011 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.