Individual
JONATHAN W SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
430 DIXIE PLZ, NATCHITOCHES, LA 71457-5881
(318) 357-9009
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 459-6795
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XHB733806675
—
LA
Enumeration date
02/27/2023
Last updated
03/03/2023
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