Individual
MR. BURNELL MARCUS SIMMONS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 435-3900
Mailing address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 455-3900
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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