Basic Information
| Provider Information | |||||||||
| NPI: | 1952072795 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMMLER | ||||||||
| FirstName: | MCKENZIE | ||||||||
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| Credential: | M.S. CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | APT 90 HOWARD DR. | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3215370166 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 508 AUTUMN SPRINGS CT STE 1A | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370678274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156148833 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2021 | ||||||||
| LastUpdateDate: | 05/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7678 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.