MEDICARE: ALLISON B SIMMONS CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SLP006388	GA

General Provider Information

NPI Number	:	1437226180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON B SIMMONS CCC-SLP

Provider Business Mailing Address
First Line	:	2426 NAPA VALLEY DR
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-5881
Country	:	US
Telephone Number	:	770-459-1225
Fax Number	:

Provider Business Practice Location Address
First Line	:	413 INDIAN HILLS TRL
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4055
Country	:	US
Telephone Number	:	770-973-3466
Fax Number	:	770-977-1582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/08/2007

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Directions to “ ALLISON B SIMMONS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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