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NPI Code Detail

MEDICARE: MICHAELA NICOLE SIMMONS RBT

MEDICARE: MICHAELA NICOLE SIMMONS RBT
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
1106S00000XBehavior TechnicianPA

General Provider Information

NPI Number : 1407512718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA NICOLE SIMMONS RBT
Provider Business Mailing Address
First Line : 2 BELLBROOK DR
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-2064
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 BELLBROOK DR
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-2064
Country : US
Telephone Number : 614-557-6467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2021
Last Update Date : 11/10/2021

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