Individual
ENDIA DOMINIQUE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1271 CRESCENT HIEGHTS RD, MARION, OH 43302
(740) 360-8910
Mailing address
527 E FAIRGROUND ST, MARION, OH 43302-2639
(740) 360-8910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.75276
OH
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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