Individual
LA'BRENA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDER
Contact information
Practice address
2751 CHATWOOD LOOP, BLACKLICK, OH 43004-3414
(614) 625-9912
Mailing address
2751 CHATWOOD LOOP, BLACKLICK, OH 43004-3414
(614) 625-9912
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172A00000X
Driver
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
10/24/2019
Last updated
06/17/2025
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