Provider Demographics
NPI:1891970612
Name:DAVIS, SUMMER LYNN (SLP)
Entity type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 BROOKVIEW DR
Mailing Address - Street 2:APT 20
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7530
Mailing Address - Country:US
Mailing Address - Phone:419-283-4469
Mailing Address - Fax:
Practice Address - Street 1:1334 BROOKVIEW DR
Practice Address - Street 2:APT 20
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615
Practice Address - Country:US
Practice Address - Phone:419-283-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8298235Z00000X
TX102274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist