Individual
HALEIGH SUMMERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 COMMERCE CT, POOLER, GA 31322-9445
(615) 560-6622
Mailing address
17358 HIGHWAY 67 UNIT 378, STATESBORO, GA 30458-2469
(229) 886-6901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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