Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C.1902012 | OH |
NPI | 1003476235 |
---|---|
Provider Name | Lauren Simms |
First Address | Columbus, OH 43220-2005 |
Second Address | Columbus, OH 43220-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2019 |
Last Update Date | 19/06/2019 |