Individual
MS. THEA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYS, LLP
Contact information
Practice address
18303 E 10 MILE RD STE 200, ROSEVILLE, MI 48066
(313) 881-7345
Mailing address
18303 E 10 MILE RD STE 200, ROSEVILLE, MI 48066-4989
(800) 693-1916
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361005071
MI
Other
Enumeration date
02/02/2014
Last updated
08/17/2022
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