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NPI Code Detail

MEDICARE: DANESHA SIMMONS

MEDICARE: DANESHA SIMMONS
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
1101Y00000XCounselorFL

General Provider Information

NPI Number : 1295365682
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANESHA SIMMONS
Provider Business Mailing Address
First Line : 3049 CLEVELAND AVE STE 290
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7054
Country : US
Telephone Number : 239-689-4745
Fax Number :
Provider Business Practice Location Address
First Line : 3049 CLEVELAND AVE STE 290
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7054
Country : US
Telephone Number : 239-689-4745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2020
Last Update Date : 01/27/2020

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Directions to “ DANESHA SIMMONS ” Practice Location

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