Provider Demographics
NPI:1952584278
Name:SIMCOX, ANN FURUSETH (PHD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:FURUSETH
Last Name:SIMCOX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1882 CREEK WOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7605
Mailing Address - Country:US
Mailing Address - Phone:507-696-2034
Mailing Address - Fax:
Practice Address - Street 1:1075 N ELM ST STE 120
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-1205
Practice Address - Country:US
Practice Address - Phone:608-348-4060
Practice Address - Fax:608-348-4191
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077441103TC0700X
WI3639-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical