Healthcare Provider Details

I. General information

NPI: 1790663375
Provider Name (Legal Business Name): SIMMONS PEDIATRIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2666 MILITARY RD
ARLINGTON VA
22207-5118
US

IV. Provider business mailing address

4141 N HENDERSON RD APT 1004
ARLINGTON VA
22203-2472
US

V. Phone/Fax

Practice location:
  • Phone: 914-879-1122
  • Fax:
Mailing address:
  • Phone: 914-879-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. AMANDA SIMMONS
Title or Position: FOUNDER
Credential: OTR/L
Phone: 914-879-1122