Provider Demographics
NPI:1033452958
Name:SIMMOMS, CRISTINA
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:SIMMOMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-7014
Mailing Address - Country:US
Mailing Address - Phone:405-535-2574
Mailing Address - Fax:
Practice Address - Street 1:1200 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-7014
Practice Address - Country:US
Practice Address - Phone:405-535-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor