Provider Demographics
NPI:1851869341
Name:SIMMS, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SIMMS
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 1:2785 ROCKBROOK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5251
Mailing Address - Country:US
Mailing Address - Phone:469-730-0925
Mailing Address - Fax:972-497-2012
Practice Address - Street 1:2785 ROCKBROOK DR STE 302
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5251
Practice Address - Country:US
Practice Address - Phone:469-730-0925
Practice Address - Fax:972-497-2012
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst