Provider Demographics
NPI:1295948693
Name:SIMMS, ALYSA RAKEL (MOT OTR L)
Entity type:Individual
Prefix:MRS
First Name:ALYSA
Middle Name:RAKEL
Last Name:SIMMS
Suffix:
Gender:F
Credentials:MOT OTR L
Other - Prefix:MS
Other - First Name:ALYSA
Other - Middle Name:RAKEL
Other - Last Name:SEALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8001 LYNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4642
Mailing Address - Country:US
Mailing Address - Phone:240-740-5500
Mailing Address - Fax:
Practice Address - Street 1:800 BRIGGS CHANEY RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-5503
Practice Address - Country:US
Practice Address - Phone:301-879-1383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04742225X00000X
MD04727171W00000X
TX111968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist