Provider Demographics
NPI:1467729327
Name:SIMMONS, RACHEL ANNE
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANNE
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 1:2802 ASBURY LN
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-6052
Mailing Address - Country:US
Mailing Address - Phone:801-703-4069
Mailing Address - Fax:
Practice Address - Street 1:7601 REDWOOD RD
Practice Address - Street 2:BLDG. E
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4007
Practice Address - Country:US
Practice Address - Phone:801-233-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)