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General NPI Number Information
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NPI Number | 1821126301
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Entity Type | Organization
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Legal Business Name | SIMON PSYCHOLOGICAL SERVICES, INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 217 SE 1ST AVE STE 200
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City | OCALA
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State | FL
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Zip | 34471-2161
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Country | US
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Telephone | 352-615-8884
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Fax | 321-247-6970
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Provider Business Mailing Address
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Address Line | PO BOX 830323
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City | OCALA
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State | FL
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Zip | 34483-0323
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Country | US
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Telephone | 352-615-8884
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Fax | 321-247-6970
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Authorized Official
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Title or Position | CEO
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Name | DR. ALISA S. TALKINGTON
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Credential | PSYD
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Telephone | 352-615-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7391
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License Number State | FL
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