Individual
MISS SAMANTHA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2848 PLEASANT RD STE 1012848, FORT MILL, SC 29708-9490
(800) 779-4089
(803) 547-9706
Mailing address
2848 PLEASANT RD STE 1012848, FORT MILL, SC 29708-9490
(800) 779-4089
(803) 547-9706
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7424
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7424
LLR
SC
Enumeration date
11/04/2020
Last updated
03/03/2022
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