Provider Demographics
NPI:1114145406
Name:SIMMONS, KATHARINE CARMICHAEL (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:CARMICHAEL
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LONGMEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-7734
Mailing Address - Country:US
Mailing Address - Phone:978-828-4331
Mailing Address - Fax:717-924-4331
Practice Address - Street 1:7 LONGMEADOW WAY
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-7734
Practice Address - Country:US
Practice Address - Phone:978-828-4331
Practice Address - Fax:717-924-4331
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4329235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist