Individual
DOROTHY AGNES SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1400 N PROVIDENCE RD STE 210, MEDIA, PA 19063-2049
(610) 891-1636
Mailing address
1400 N PROVIDENCE RD STE 210, MEDIA, PA 19063-2049
(610) 891-1636
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
012657
PA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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