Martha E Phillips, LISW-S, LICDC

NPI #1285965764 in Defiance, Ohio

Provider Information

NPI Number: 1285965764
Entity Type: Individual
Name: Martha E Phillips, LISW-S, LICDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LISW-S, LICDC
Enumeration Date: Jan 22, 2010
Last Updated: Jan 22, 2010

Practice Location

Address: 815 E 2ND ST
City: Defiance
State: Ohio
ZIP Code: 43512-2308
Phone: (419) 267-1245

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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