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Individual

JENNIFER DIANNE SIMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC-S

Contact information

Practice address
179 BROAD ST, CONNEAUT, OH 44030
(440) 606-6334
Mailing address
292 N AMBOY RD, CONNEAUT, OH 44030-3097
(440) 606-6334

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.1100399
OH
101YP2500X
Professional Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0200131
OH
Enumeration date
10/31/2016
Last updated
09/04/2018
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