Most Relevant Information
Provider Data
| NPI Number: | 1003695768 |
| Provider Name: | LORRI ELIZABETH SIMMONS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/22/2023 |
| Last Updated: | 09/22/2023 |
Provider Practice Location
1651 E NICKERSON AVE
BENTON HARBOR
MI
490222469
Practice Location Phone/Fax
| Phone: | 2698765697 |
| Fax: | 2693593730 |
Provider Mailing Location
1651 E NICKERSON AVE
BENTON HARBOR
MI
490222469
Provider Mailing Phone/Fax
| Phone: | 2698765697 |
| Fax: | 2693593730 |