Individual
DR. CHERRY GRANT SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD IN COUNSELING
Contact information
Practice address
420 CEDAR ST, JESUP, GA 31546-3520
(912) 559-2636
Mailing address
PO BOX 22, JESUP, GA 31598-0022
(912) 559-2636
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
03168952
GA
101YP1600X
Pastoral Counselor
Primary
03168952
GA
101YP2500X
Professional Counselor
03168952
GA
106H00000X
Marriage & Family Therapist
03168952
GA
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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