Simelton, Tijuana

Simelton, Tijuana is an individual health care provider with primary practice located at 2434 S Eason Blvd , Tupelo MS 38804-6942. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Simelton, Tijuana can be contacted via phone (662) 640-4595.

Contact Information

Primary practice address
2434 S Eason Blvd Tupelo MS 38804-6942
Phone: (662) 640-4595
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X Arkansas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1295827558
LBN Legal business name Simelton, Tijuana
Credentials B.S., MHA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Nov 29th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295827558 NPPES
Tennessee MEDICAID 734965000

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