Provider Information for 1518557248
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STACI SIMMERMAN MA, LPC
Sex: Female
NPI: 1518557248
Last Updated: 2023-03-07
Certification Date: 2023-03-07
Certification Date: 2023-03-07
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518557248 | ||||||||||||
| Enumeration Date | 2021-01-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 300 E 17TH STREET CHEYENNE, WY 82001-4608 United States Phone: 307-631-9931 | Fax:307-635-7706 | ||||||||||||
| Primary Practice Address | 300 E 17TH STREET CHEYENNE, WY 82001-4608 United States Phone: 307-631-9931 | Fax:307-635-7706 | ||||||||||||
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