Individual
TAMIKA SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3120 N OAK ST, VALDOSTA, GA 31602-1003
(229) 671-6125
(229) 671-6774
Mailing address
3120 N OAK STREET EXT STE B, VALDOSTA, GA 31602-5910
(229) 671-6100
(229) 671-6774
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001305
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001305
LICENSE
GA
Enumeration date
10/02/2013
Last updated
10/02/2013
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