Individual
LAURA GRACE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, CD
Contact information
Practice address
2713 W PECAN RD, PHOENIX, AZ 85041-4421
(253) 470-8399
(866) 540-3225
Mailing address
2713 W PECAN RD, PHOENIX, AZ 85041-4421
(253) 470-8399
(866) 540-3225
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2019039025
MO
133V00000X
Registered Dietitian
Primary
86119587
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61078483
WA STATE DOH
WA
Enumeration date
10/21/2019
Last updated
10/16/2024
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