Individual
DR. LYDA MONELL SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.,L.P.C.
Contact information
Practice address
110 JAMESON DR, ROEBUCK, SC 29376-3527
(864) 587-4877
(864) 587-4877
Mailing address
110 JAMESON DR, ROEBUCK, SC 29376-3527
(864) 587-4877
(864) 587-4877
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
13390
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
429691
MHN
—
05
—
LP0021006
—
TX
Enumeration date
12/20/2008
Last updated
12/20/2008
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