| Doctor Name: | DR. KEVIN R SIMONSON |
| NPI Number: | 1689013138 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 05103 |
| Business Practice Address: | 101 Braddock Rd Frostburg State University 101 Sand Spring Hall Frostburg, MD - 21532 |
| Business Phone Number: | 8459136725 |
| Business Fax Number: | |
| Mailing Address: | 629 Patterson Ave, CUMBERLAND |
| State: | MD |
| Postal Code: | 215023350 |
| Phone Number: | 8459136725 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2013 |
| NPI Last Update Date: | 06/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 05103 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |