Provider Demographics
NPI:1639319775
Name:SIMONSMEIER, VICKI L (MS)
Entity Type:Individual
Prefix:PROF
First Name:VICKI
Middle Name:L
Last Name:SIMONSMEIER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 OLD MAIN HILL
Mailing Address - Street 2:DEPARTMENT OF COMMUNICATIVE DISORDERS
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84322-1000
Mailing Address - Country:US
Mailing Address - Phone:435-797-7554
Mailing Address - Fax:435-797-0221
Practice Address - Street 1:DEPARTMENT OF COMMUNICATIVE DISORDERS
Practice Address - Street 2:1000 OLD MAIN HILL
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-0001
Practice Address - Country:US
Practice Address - Phone:435-797-7554
Practice Address - Fax:435-797-0221
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3082715-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist