Individual
ELLA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
279 WAGNER ST, ALLENDALE, SC 29810-5743
(803) 671-5317
Mailing address
PO BOX 223, ALLENDALE, SC 29810-0223
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
SC
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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