Organization
STEPHANIE SUMMERS LMFT, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ANN SUMMERS LMFT (OFFICER)
(904) 268-9178
Entity
Organization
Contact information
Practice address
12412 SAN JOSE BLVD, SUITE 102C, JACKSONVILLE, FL 32223-8621
(904) 268-9178
Mailing address
12412 SAN JOSE BLVD, SUITE 102C, JACKSONVILLE, FL 32223-8621
(904) 268-9178
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2128
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT2128
PROFESSIONAL LICENSE NUMB
FL
Enumeration date
03/30/2007
Last updated
03/11/2008
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