Provider Demographics
NPI:1215733803
Name:PAULING, SUMMER ANNE
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:ANNE
Last Name:PAULING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 SW REGENCY PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7753
Mailing Address - Country:US
Mailing Address - Phone:479-252-3321
Mailing Address - Fax:479-668-2257
Practice Address - Street 1:3108 SW REGENCY PKWY STE 5
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7753
Practice Address - Country:US
Practice Address - Phone:479-252-3321
Practice Address - Fax:479-668-2257
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR4051225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist