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NPI Code Detail

MEDICARE: AYANA KAFI SIMMONS PSYD, LP

MEDICARE: AYANA KAFI SIMMONS PSYD, LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6301014394MI
2103TC0700XClinical Psychologist6351000977MI
3103TC0700XClinical Psychologist6301017258MI

General Provider Information

NPI Number : 1326460734
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYANA KAFI SIMMONS PSYD, LP
Provider Business Mailing Address
First Line : 3200 GREENFIELD RD STE 300
Second Line :
City : DEARBORN
State : MI
Zip : 48120-1805
Country : US
Telephone Number : 313-420-3329
Fax Number :
Provider Business Practice Location Address
First Line : 3200 GREENFIELD RD STE 300
Second Line :
City : DEARBORN
State : MI
Zip : 48120-1805
Country : US
Telephone Number : 313-420-3329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2014
Last Update Date : 04/12/2024

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