Individual
CARMEN MICHELLE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 CRESTWOOD RD, MAYFIELD HTS, OH 44124-3332
(216) 832-7549
Mailing address
1609 CRESTWOOD RD, MAYFIELD HTS, OH 44124-3332
(216) 832-7549
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1819161
—
OH
Enumeration date
10/06/2020
Last updated
10/08/2020
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