Provider Demographics
NPI:1952771909
Name:SIMMONS-PETERSON, FELICIA LATRICE (QMHP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:LATRICE
Last Name:SIMMONS-PETERSON
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 BOVINE DR APT 7202
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-0017
Mailing Address - Country:US
Mailing Address - Phone:318-229-3579
Mailing Address - Fax:
Practice Address - Street 1:5501 BOVINE DR APT 7202
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-0017
Practice Address - Country:US
Practice Address - Phone:318-229-3579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management