| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IESHA T PHELPS | 1811634553 | 2022-05-15 |
Iesha T Phelps is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1811634553. Registration indicates Iesha T Phelps is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Specialist/Technologist (Specialist/Technologist, ) (Specialist/Technologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Behavioral Health & Social Service Providers, Behavior Technician) (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Iesha T Phelps |
| Practice Office Address | 1081 OAK ST STE 3 PITTSTON, PA US |
| Practice Office Telephone | 8887264774 |
| Practice Office Fax | 5703625112 |
| Mailing Address | 9 BANKS AVE MCADOO, PA 182372508 US |
| Business Telephone | 8887264774 |
| Business Fax | 5703625112 |
| Code | Practice | License No State |
|---|---|---|
| 225500000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Specialist/Technologist Specialist/Technologist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | |
| 193400000X SING | Group Code |