Provider Demographics
NPI:1497229488
Name:SIMPSON, ALLAN JERROD
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:JERROD
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6371 EUCLID AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5625
Mailing Address - Country:US
Mailing Address - Phone:443-596-9630
Mailing Address - Fax:
Practice Address - Street 1:6371 EUCLID AVE UNIT A
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5625
Practice Address - Country:US
Practice Address - Phone:443-596-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician