Doctor Name: | MRS. ASHLEY ANN REYNOLDS SIMMONS |
NPI Number: | 1124358676 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S. |
License Number: | |
Business Practice Address: | 504 E 24th St Tishomingo, OK - 734603214 |
Business Phone Number: | 5803719933 |
Business Fax Number: | 5803719944 |
Mailing Address: | 32794 State Highway 99 S, STONEWALL |
State: | OK |
Postal Code: | 748716128 |
Phone Number: | 5803104719 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2010 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |