Provider Demographics
NPI:1407217532
Name:GLASS, SUMMER
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:GLASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6683
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-750-4843
Practice Address - Street 1:1200 W WALNUT ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3521
Practice Address - Country:US
Practice Address - Phone:479-878-1766
Practice Address - Fax:479-750-4843
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker