Most Relevant Information
Provider Data
| NPI Number: | 1003503046 |
| Provider Name: | JEANNINE RUTH SIMS |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 11881901 |
Most Important Dates
| Enumeration Date: | 04/20/2023 |
| Last Updated: | 04/20/2023 |
Provider Practice Location
50 W HAWTHORNE AVE
VALLEY STREAM
NY
115806223
Practice Location Phone/Fax
| Phone: | 5165696600 |
| Fax: |
Provider Mailing Location
50 W HAWTHORNE AVE
VALLEY STREAM
NY
115806223
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |