Individual
MS. GINA SIMON
Active
Individual
MS. GINA SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-3207
NM
1041C0700X
Clinical Social Worker
I-3207
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28487079
—
NM
01
—
D4495
DD WAIVER PROVIDER
NM
01
—
NM000181
VALUE OPTIONS
NM
Enumeration date
01/12/2007
Last updated
04/27/2023
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