Individual
LATOYA YOLANDA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
Mailing address
2444 HUNTERS TRL, MYRTLE BEACH, SC 29588-8444
(843) 236-9481
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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