Individual
MISS THERESA L SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 CASTLE WAY, CARSON CITY, NV 89706-1932
(775) 720-4284
Mailing address
11 CASTLE WAY, CARSON CITY, NV 89706-1932
(775) 720-4284
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134499015
—
NV
Enumeration date
12/05/2012
Last updated
12/05/2012
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