Provider Demographics
NPI:1770636532
Name:SIMMONS, VICTORIA (MFT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4269
Mailing Address - Country:US
Mailing Address - Phone:775-882-0687
Mailing Address - Fax:775-882-9043
Practice Address - Street 1:205 S MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4269
Practice Address - Country:US
Practice Address - Phone:775-882-0687
Practice Address - Fax:775-882-9043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0980106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVRNO7715OtherREGISTERED NURSE