Individual
MRS. STACEY MICHELLE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
545 OLD NORCROSS RD STE 100, LAWRENCEVILLE, GA 30046-3390
(678) 377-2833
(678) 377-2882
Mailing address
545 OLD NORCROSS RD STE 100, LAWRENCEVILLE, GA 30046-3390
(678) 377-2833
(678) 377-2882
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005714
GA
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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