Provider Demographics
NPI:1760514251
Name:SIMS, DANA LYNN (MS SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LYNN
Last Name:SIMS
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MOUNTAIN COVE RD
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2057
Mailing Address - Country:US
Mailing Address - Phone:423-710-4818
Mailing Address - Fax:423-305-0157
Practice Address - Street 1:6849 PRESTIGE LN STE 133
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-2686
Practice Address - Country:US
Practice Address - Phone:423-508-8212
Practice Address - Fax:423-305-0157
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ019408Medicaid