Provider Demographics
NPI:1043582448
Name:SIMMONS, AMBER (MOTR/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1556
Mailing Address - Country:US
Mailing Address - Phone:301-438-3023
Mailing Address - Fax:
Practice Address - Street 1:3701 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1556
Practice Address - Country:US
Practice Address - Phone:301-438-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1567225X00000X
MD07214225X00000X
DCOTO10001090225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist