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Individual

ELLEN SIMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
234 SHAWNEE CT, O FALLON, IL 62269-8702
(618) 702-9163
Mailing address
234 SHAWNEE CT, O FALLON, IL 62269-8702
(618) 702-9163

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146017381
IL
235Z00000X
Speech-Language Pathologist
SP-1960
NV

Other

Enumeration date
06/27/2016
Last updated
11/14/2023
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