Provider Demographics
NPI:1033528526
Name:SIMMONS, YOLANDA RAYCHEL (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:RAYCHEL
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 N GUIGNARD DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150
Mailing Address - Country:US
Mailing Address - Phone:803-773-5567
Mailing Address - Fax:803-775-4293
Practice Address - Street 1:1018 N GUIGNARD DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150
Practice Address - Country:US
Practice Address - Phone:803-773-5567
Practice Address - Fax:803-775-4293
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant