Individual
HEATHER MARIE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
303 PINEVIEW DR, WAYCROSS, GA 31501-5229
(912) 283-0777
Mailing address
303 PINEVIEW DR, WAYCROSS, GA 31501-5229
(912) 283-0777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008050
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003130506B
—
GA
Enumeration date
12/06/2012
Last updated
09/19/2013
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