Provider Demographics
NPI:1497347835
Name:SIMONSEN, CECILIE CLAIRE (SLP)
Entity Type:Individual
Prefix:
First Name:CECILIE
Middle Name:CLAIRE
Last Name:SIMONSEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 ALICE LN APT 5
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5151
Mailing Address - Country:US
Mailing Address - Phone:734-277-2391
Mailing Address - Fax:
Practice Address - Street 1:321 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-3500
Practice Address - Country:US
Practice Address - Phone:734-277-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist