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Individual

MS. DIMONIQUE SIMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
5575 CONNER ST STE 204B, DETROIT, MI 48213-6401
(248) 716-4910
(248) 522-7045
Mailing address
5575 CONNER ST STE 204B, DETROIT, MI 48213-6401
(248) 716-4910

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015911
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6401015911
MI
Enumeration date
01/18/2018
Last updated
01/18/2018
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