Organization
WILLIE SIMMONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE A SIMMONS LICSWC (MR.)
(240) 432-9338
Entity
Organization
Contact information
Practice address
12500 CLEARWATER WAY, UPPER MARLBORO, MD 20772-6600
(240) 432-9338
Mailing address
12500 CLEARWATER WAY, UPPER MARLBORO, MD 20772-6600
(240) 432-9338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
20930
MD
251S00000X
Community/Behavioral Health Agency
LC50079182
DC
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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