Provider Demographics
NPI:1770655706
Name:PARLOW, SIMMIE J (PHD)
Entity type:Individual
Prefix:DR
First Name:SIMMIE
Middle Name:J
Last Name:PARLOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 MEROLD DR
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2258
Mailing Address - Country:US
Mailing Address - Phone:952-303-4163
Mailing Address - Fax:952-303-4185
Practice Address - Street 1:5809 MEROLD DR
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-2258
Practice Address - Country:US
Practice Address - Phone:952-303-4163
Practice Address - Fax:952-303-4185
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2888103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2H186PAOtherBLUE CROSS
MN830053400Medicaid
MN61-08958OtherMEDICA