Provider Demographics
NPI:1972922763
Name:PHILLIPS, LINDA KAY (CRT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KAY
Other - Last Name:POUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19372 N KARI LN
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-6933
Mailing Address - Country:US
Mailing Address - Phone:520-488-8787
Mailing Address - Fax:
Practice Address - Street 1:19372 N. KARI LN
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139
Practice Address - Country:US
Practice Address - Phone:520-488-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008837227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified