Provider Demographics
NPI:1912607920
Name:SUMMERS, CHRISTY RENAE (RBT)
Entity type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:RENAE
Last Name:SUMMERS
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 573
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:OK
Mailing Address - Zip Code:74730-0573
Mailing Address - Country:US
Mailing Address - Phone:931-252-4215
Mailing Address - Fax:
Practice Address - Street 1:107 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-4700
Practice Address - Country:US
Practice Address - Phone:580-706-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-22-219028106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician