Provider Demographics
NPI:1497440275
Name:SIMMONS, YULANDAR SUE
Entity Type:Individual
Prefix:
First Name:YULANDAR
Middle Name:SUE
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 1:355 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:SC
Mailing Address - Zip Code:29810-3537
Mailing Address - Country:US
Mailing Address - Phone:863-314-7402
Mailing Address - Fax:
Practice Address - Street 1:355 PEARL ST
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:SC
Practice Address - Zip Code:29810-3537
Practice Address - Country:US
Practice Address - Phone:863-314-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health