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Individual

MR. GREGORY DWAYNE SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
20400 COLONEL GLENN RD, LITTLE ROCK, AR 72210
(501) 821-5500
Mailing address
20400 COLONEL GLENN RD, LITTLE ROCK, AR 72210-5323

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71-0399069
AR
Enumeration date
09/24/2019
Last updated
09/24/2019
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