Individual
THERESA E SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 LAUREL AVE, GOOSE CREEK, SC 29445-3025
(843) 270-0607
Mailing address
206 LAUREL AVE, GOOSE CREEK, SC 29445-3025
(843) 270-0607
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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