Individual
MS. MARY THERESA SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1782
(570) 346-3686
(570) 558-6838
Mailing address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1782
(570) 346-3686
(570) 558-6838
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP016910
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015023708
PMHNP
—
01
—
SP016910
PENNSYLVANIA CERTIFIED REGISTERED NURSE PRACTITIONER-PSYCHIATRIC MENTAL HEALTH
PA
Enumeration date
02/06/2007
Last updated
02/27/2017
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