Individual
KA-LISHA MAE SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1450 FERN CREEK DR, STATESVILLE, NC 28625-9376
(704) 818-9191
(704) 872-3782
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2024-00805
NC
2084P0800X
Psychiatry Physician
25MA11444800
NJ
Other
Enumeration date
05/09/2019
Last updated
10/31/2024
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