Provider Demographics
NPI:1083320691
Name:SIMMONDS, KHNUMA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:KHNUMA
Middle Name:E
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00821-0071
Mailing Address - Country:US
Mailing Address - Phone:340-514-8008
Mailing Address - Fax:
Practice Address - Street 1:4031 LA GRANGE PRINCESSE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00821
Practice Address - Country:US
Practice Address - Phone:340-473-9502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor