Most Relevant Information
Provider Data
| NPI Number: | 1003459280 |
| Provider Name: | LAURA GRACE SIMMONS MS, RDN, CD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 2019039025 |
Most Important Dates
| Enumeration Date: | 10/21/2019 |
| Last Updated: | 10/16/2024 |
Provider Practice Location
2713 W PECAN RD
PHOENIX
AZ
850414421
Practice Location Phone/Fax
| Phone: | 2534708399 |
| Fax: | 8665403225 |
Provider Mailing Location
2713 W PECAN RD
PHOENIX
AZ
850414421
Provider Mailing Phone/Fax
| Phone: | 2534708399 |
| Fax: | 8665403225 |