Provider Demographics
NPI:1427067396
Name:PHILLIPS, PATRICIA LYNN (CTRS, CADCIII)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:CTRS, CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 TOPEKA LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2721
Mailing Address - Country:US
Mailing Address - Phone:785-842-9814
Mailing Address - Fax:
Practice Address - Street 1:4101 SOUTH 4TH ST TFFWY
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-9951
Practice Address - Country:US
Practice Address - Phone:913-682-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist