Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS016042 | PA |
Y | 103TC0700X | Clinical Psychologist | PS016042 | PA |
N | 103G00000X | Clinical Psychologist | 35S100472500 | NJ |
N | 103TC0700X | Clinical Psychologist | 35S100472500 | NJ |
N | 103G00000X | Clinical Psychologist | PS016042 | PA |
N | 103TC0700X | Clinical Psychologist | PS016042 | PA |
N | 103TR0400X | Rehabilitation Psychologist | PS016042 | PA |
NPI | 1366752503 |
---|---|
Provider Name | Dr. Cynthia B Simonds |
First Address | Malvern, PA 19355-3311 |
Second Address | Malvern, PA 19355-3311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 12/11/2012 |