Individual
TAQUISA KATINA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
212 RESEARCH DR, SUITE 102, CHESAPEAKE, VA 23320-5984
(757) 673-8117
(757) 673-8127
Mailing address
724 BRISA CT, CHESAPEAKE, VA 23322-7155
(757) 404-1900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710101902
VA
1041C0700X
Clinical Social Worker
0904006264
VA
Other
Enumeration date
08/17/2006
Last updated
08/21/2008
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