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NPI Code Detail

MEDICARE: LINDA WRIGHT SIMMONS DMIN, MA

MEDICARE: LINDA WRIGHT SIMMONS DMIN, MA
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
1101YM0800XMental Health CounselorIMH20131FL

General Provider Information

NPI Number : 1598442543
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA WRIGHT SIMMONS DMIN, MA
Provider Business Mailing Address
First Line : 641 BLAIRSHIRE CIR
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-4713
Country : US
Telephone Number : 407-421-9034
Fax Number :
Provider Business Practice Location Address
First Line : 121 W PENNSYLVANIA AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3429
Country : US
Telephone Number : 407-421-9034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2023
Last Update Date : 07/17/2023

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