Provider Demographics
NPI:1215649231
Name:SIMS, LEIGH-KIRSTIN DANIELS (MED)
Entity type:Individual
Prefix:
First Name:LEIGH-KIRSTIN
Middle Name:DANIELS
Last Name:SIMS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5414
Mailing Address - Country:US
Mailing Address - Phone:703-688-2654
Mailing Address - Fax:
Practice Address - Street 1:600 14TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5414
Practice Address - Country:US
Practice Address - Phone:703-688-2654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPGP-0688891222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist