Individual
TAKELIA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1014 WASHINGTON AVE, LA PLATA, MD 20646-4228
(240) 462-3562
Mailing address
1037 RYE DR, LA PLATA, MD 20646-3241
(240) 462-3562
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R243046
MD
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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