Shane Cyrenus Phillips

NPI #1073199014 in O Fallon, Illinois

Provider Information

NPI Number: 1073199014
Entity Type: Individual
Name: Shane Cyrenus Phillips
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 21, 2021
Last Updated: Mar 21, 2021

Practice Location

Address: 6 EAGLE CTR STE 1
City: O Fallon
State: Illinois
ZIP Code: 62269-1945
Phone: (844) 244-1818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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