| Doctor Name: | DR. DAVID R. SIMONS |
| NPI Number: | 1053310029 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 20040248A |
| Business Practice Address: | 1506 Osolo Rd Suite A Elkhart, IN - 465144122 |
| Business Phone Number: | 5745233347 |
| Business Fax Number: | 5742069502 |
| Mailing Address: | 1506 Osolo Rd, Suite A ELKHART |
| State: | IN |
| Postal Code: | 465144122 |
| Phone Number: | 5745233347 |
| Fax Number: | 5742069502 |
| NPI Enumeration Date: | 07/20/2005 |
| NPI Last Update Date: | 11/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 20040248A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |