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General NPI Number Information
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NPI Number | 1932634292
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Entity Type | Organization
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Legal Business Name | SIMMS & SIMMS
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 42 E FRONT ST
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City | MEDIA
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State | PA
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Zip | 19063-2912
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Country | US
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Telephone | 267-738-5912
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Fax |
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Provider Business Mailing Address
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Address Line | 42 E FRONT ST
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City | MEDIA
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State | PA
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Zip | 19063-2912
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Country | US
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Telephone | 267-738-5912
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. STEVEN GLEN SIMMS
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Credential | PH.D.
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Telephone | 267-738-5912
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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 | 008173-L
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License Number State | PA
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