Individual
TIMOTHY JASON SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48329
(248) 409-4245
Mailing address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 409-4245
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401016257
MI
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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