Individual
CRIQUET SUMMERLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
86 MARTHA ST, ALLENHURST, GA 31301-2684
(954) 654-3322
Mailing address
86 MARTHA ST, ALLENHURST, GA 31301-2684
(954) 654-3322
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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