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General NPI Number Information
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NPI Number | 1225454119
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Entity Type | Organization
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Legal Business Name | GEORGE K. SIMON, JR., PHD, PA
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Dates
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Enumeration Date | 03/15/2014
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Last Update Date | 03/15/2014
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Provider Practice Location Address
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Address Line | 415 N MCKINLEY ST #1040
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3013
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Country | US
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Telephone | 501-663-5075
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Fax | 501-224-2680
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Provider Business Mailing Address
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Address Line | 415 N MCKINLEY ST #1040
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3013
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Country | US
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Telephone | 501-663-5075
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Fax | 501-224-2680
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHERYL LYNN SIMON
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Credential | PHD
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Telephone | 501-663-5075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 86-19P
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License Number State | AR
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