Individual
MRS. CHRISTINE LYNN SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
30 ANDYS LN, EASTPORT, NY 11941-1329
(631) 806-8389
Mailing address
30 ANDYS LN, EASTPORT, NY 11941-1329
(631) 806-8389
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
07387-1
NY
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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