Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEYONTA LATRISE JOHNSON- SIMS
Active Sole ProprietorKEYONTA LATRISE JOHNSON- SIMS is a Adult Development & Aging Psychologist healthcare provider located in WEST BEND, Wisconsin. NPI 1417749755 is currently active in the NPPES registry. Verify at CMS.
Adult Development & Aging Psychologist · WEST BEND, WI
Registration Details
- NPI Number
- 1417749755
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 21, 2025 (1.260405673581 yrs)
- Last Updated
- May 21, 2025
- License
-
0020200 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1871 WALLACE LAKE RDWEST BEND, WI, 530909074Browse WI providers · Browse ZIP 53090
- Phone
- 4149151531
- Primary Specialty
-
Adult Development & Aging Psychologist
103TA0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.