| Suzan B. Simmons, Ph.d,,pllc | |
|
1916 Lake Rd Ponca City OK 74604-4800 | |
| (580) 761-3799 | |
| Not Available |
| Full Name | Suzan B. Simmons, Ph.d,,pllc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 1916 Lake Rd, Ponca City, Oklahoma |
| Authorized Official Name and Position | Suzan B Simmons (PSYCHOLOGIST) |
| Authorized Official Contact | 5807613799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suzan B. Simmons, Ph.d,,pllc Po Box 1230 Ponca City OK 74602-1230 Ph: (580) 761-3799 | Suzan B. Simmons, Ph.d,,pllc 1916 Lake Rd Ponca City OK 74604-4800 Ph: (580) 761-3799 |
| NPI Number | 1164887170 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 12/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164887170 | NPI | - | NPPES |
| OKA104155 | Other | OK | MEDICARE INDIVIDUAL PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 1150 (Oklahoma) | Primary |
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