Provider Demographics
NPI:1306406111
Name:SIMMONS, SAVANNAH BROOKE
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:BROOKE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 WOODSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-8920
Mailing Address - Country:US
Mailing Address - Phone:318-730-1933
Mailing Address - Fax:
Practice Address - Street 1:401 MARKET ST STE 810
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2846
Practice Address - Country:US
Practice Address - Phone:740-314-5339
Practice Address - Fax:740-314-5527
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management