Provider Demographics
NPI:1912280413
Name:SIMPSON, LUNA MONIQUE (RMA)
Entity type:Individual
Prefix:MRS
First Name:LUNA
Middle Name:MONIQUE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:MRS
Other - First Name:LUNA
Other - Middle Name:MONIQUE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RMA
Mailing Address - Street 1:18621 SNOWDEN ST # 2B
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1363
Mailing Address - Country:US
Mailing Address - Phone:734-623-9781
Mailing Address - Fax:
Practice Address - Street 1:18621 SNOWDEN ST # 2B
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1363
Practice Address - Country:US
Practice Address - Phone:734-623-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2025-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID8J6B5T7146M00000X
MI7471804372500000X
MI173C00000X, 175F00000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No372500000XNursing Service Related ProvidersChore Provider
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7471804Medicaid