Individual
MS. CHANEL SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
1550 PRATT ST, PHILA, PA 19124-1923
(215) 828-9840
Mailing address
5617 DIAMOND ST, PHILA, PA 19131-3122
(215) 828-9840
Taxonomy
Speciality
Code
Description
License number
State
231HA2500X
Assistive Technology Supplier Audiologist
Primary
AT006106
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022402230001
—
PA
Enumeration date
12/03/2008
Last updated
07/14/2010
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