Individual
STEPHANIE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 N 155TH ST, BASEHOR, KS 66007-7100
(620) 704-6548
Mailing address
1106 N 155TH ST, BASEHOR, KS 66007-7100
(620) 704-6548
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/04/2013
Last updated
04/17/2023
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