Individual
KAYLA SUMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 FERN AVE, GRAND MARSH, WI 53936-9683
(847) 802-0283
Mailing address
1046 FERN AVE, GRAND MARSH, WI 53936-9683
(847) 802-0283
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1851860092
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
1851860092
WI
Other
Enumeration date
11/16/2018
Last updated
03/13/2025
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