Individual
WYDIA TAMIKA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 N PRESTON ST, PHILA, PA 19104-2211
(610) 891-2000
Mailing address
12 N PRESTON ST, PHILA, PA 19104-2211
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
SW134059
PA
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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