Organization
SIMMONS EARLY INTERVENTION THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHONTA TONEIK SIMMONS BS, ITFS (EARLY INTERVENTION THERAPIST)
(919) 344-5890
Entity
Organization
Contact information
Practice address
110 HINES DR, GOLDSBORO, NC 27534-8630
(919) 344-5890
(919) 751-2320
Mailing address
110 HINES DR, GOLDSBORO, NC 27534-8630
(919) 344-5890
(919) 751-2320
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301201
—
NC
05
—
8301201K
—
NC
Enumeration date
04/13/2007
Last updated
08/22/2020
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