Individual
MADISON SIMMS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD, SUITE 600, MC LEAN, VA 22102-4311
(800) 828-5659
Mailing address
4605 CALVERT RD, APT 201, COLLEGE PARK, MD 20740-3421
(443) 789-4831
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-22205
DC
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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