Provider Demographics
NPI:1801781729
Name:SIMS, EDWANA DENE'
Entity type:Individual
Prefix:
First Name:EDWANA
Middle Name:DENE'
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 ROSWELL RD UNIT 485
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3938
Mailing Address - Country:US
Mailing Address - Phone:601-882-3446
Mailing Address - Fax:601-882-3446
Practice Address - Street 1:6125 ROSWELL RD UNIT 485
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3938
Practice Address - Country:US
Practice Address - Phone:601-882-3446
Practice Address - Fax:601-882-3446
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician