Provider Demographics
NPI:1245006329
Name:JESSICA T SIMONS
Entity type:Organization
Organization Name:JESSICA T SIMONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, LMFT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:TOP
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:435-200-3102
Mailing Address - Street 1:2926 S WOODROW LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-3646
Mailing Address - Country:US
Mailing Address - Phone:435-200-3102
Mailing Address - Fax:
Practice Address - Street 1:2926 S WOODROW LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3646
Practice Address - Country:US
Practice Address - Phone:435-200-3102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty