Individual
CARMEL YVETTE SUMMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
965 BURTON RAY ST NE, LACEY, WA 98516-7603
(360) 605-0163
Mailing address
5918 56TH AVE W APT D13, UNIVERSITY PLACE, WA 98467-3500
(253) 223-8829
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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