MRS. Michelle Theresa Petrillo Phan
NPI #1033824974 in Newport Beach, California
Provider Information
- NPI Number
- 1033824974
- Entity Type
- Individual
- Name
- MRS. Michelle Theresa Petrillo Phan
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- Jan 16, 2023
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 1151 DOVE ST
- City
- Newport Beach
- State
- California
- ZIP Code
- 92660-2840
- Phone
- (949) 630-8290
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
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