Provider Demographics
NPI:1750390407
Name:SIMONS, MARIA ANNE (CIT)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ANNE
Last Name:SIMONS
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7118
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306-0118
Mailing Address - Country:US
Mailing Address - Phone:318-587-5194
Mailing Address - Fax:
Practice Address - Street 1:401 RAINBOW DR UNIT 35
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6979
Practice Address - Country:US
Practice Address - Phone:318-587-5194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2188101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)