Provider Demographics
NPI:1215241468
Name:TODD, SUMMER RENEE (MA)
Entity type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:RENEE
Last Name:TODD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:SUMMER
Other - Middle Name:RENEE
Other - Last Name:HUNKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4890 32ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-9350
Mailing Address - Country:US
Mailing Address - Phone:503-588-5647
Mailing Address - Fax:503-588-0509
Practice Address - Street 1:4890 32ND AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97317-9350
Practice Address - Country:US
Practice Address - Phone:503-588-5647
Practice Address - Fax:503-588-0509
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health