Provider Demographics
NPI:1962757880
Name:SIMS, VALERIE ANNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANNE
Last Name:SIMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:MOODY
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:277 FYKE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-4165
Mailing Address - Country:US
Mailing Address - Phone:423-920-4898
Mailing Address - Fax:
Practice Address - Street 1:277 FYKE DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4165
Practice Address - Country:US
Practice Address - Phone:423-920-4898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4656235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532101Medicaid