Provider Demographics
NPI:1134929912
Name:SIMUNS, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SIMUNS
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 1:1724 FAIRVIEW AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7873
Mailing Address - Country:US
Mailing Address - Phone:406-282-1496
Mailing Address - Fax:
Practice Address - Street 1:1724 FAIRVIEW AVE STE A
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7873
Practice Address - Country:US
Practice Address - Phone:406-207-1027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-789281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical