Individual
DR. JEANETTE MARITZA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3505 FREDERICK AVE, SAINT JOSEPH, MO 64506-2914
(816) 387-2300
(816) 387-2769
Mailing address
3505 FREDERICK AVE, SAINT JOSEPH, MO 64506-2914
(816) 387-2300
(816) 387-2769
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2002030478
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498333509
—
MO
Enumeration date
09/20/2006
Last updated
04/27/2010
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