Provider Demographics
NPI:1154442747
Name:SIMMONS, TERRICA NICOLE (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:TERRICA
Middle Name:NICOLE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:156 PHILLIPS 323
Mailing Address - Street 2:
Mailing Address - City:WEST HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72390-9597
Mailing Address - Country:US
Mailing Address - Phone:870-316-5942
Mailing Address - Fax:870-572-2156
Practice Address - Street 1:515 MCDONOUGH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-2912
Practice Address - Country:US
Practice Address - Phone:870-338-8106
Practice Address - Fax:870-338-8106
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA2115225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant