Provider Demographics
NPI:1306318514
Name:CARBONE, SUMMER NIKOLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:NIKOLE
Last Name:CARBONE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14995 SHADY GROVE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8727
Mailing Address - Country:US
Mailing Address - Phone:301-560-2603
Mailing Address - Fax:
Practice Address - Street 1:14995 SHADY GROVE RD STE 200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8727
Practice Address - Country:US
Practice Address - Phone:301-560-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist