Provider Demographics
NPI:1497007512
Name:SIMMONS, JESSICA LYNN
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5323
Mailing Address - Country:US
Mailing Address - Phone:918-740-5211
Mailing Address - Fax:
Practice Address - Street 1:414 MARGARET DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5323
Practice Address - Country:US
Practice Address - Phone:918-740-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health