Individual
THELMA ROSE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, BSW
Contact information
Practice address
112 NORTH RESERVATION ROAD, FORT MCDERMITT INDIAN HEALTH SERVICE, MCDERMITT, NV 89421
(775) 532-8522
(775) 532-8024
Mailing address
9714 MARGARITA STREET, MCDERMITT, NV 89421
(775) 532-8522
(775) 532-8204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
767-L
NV
Other
Enumeration date
05/15/2012
Last updated
08/01/2013
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