Most Relevant Information
Provider Data
| NPI Number: | 1003380643 |
| Provider Name: | KAITLAN PHILLIPS LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 21503 |
Most Important Dates
| Enumeration Date: | 01/16/2019 |
| Last Updated: | 01/16/2019 |
Provider Practice Location
19 RIDGE RD
RISING SUN
MD
219111545
Practice Location Phone/Fax
| Phone: | 3028249636 |
| Fax: |
Provider Mailing Location
19 RIDGE RD
RISING SUN
MD
219111545
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |