Basic Information
| Provider Information | |||||||||
| NPI: | 1992207518 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMS | ||||||||
| FirstName: | MURPHY | ||||||||
| MiddleName: | LLIE MEGAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1136 MULBERRY LN | ||||||||
| Address2: | |||||||||
| City: | MARIANNA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 324487290 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 879 USERY RD | ||||||||
| Address2: | |||||||||
| City: | CHIPLEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 324289303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506384654 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2018 | ||||||||
| LastUpdateDate: | 02/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 15898 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.