Provider Demographics
NPI:1083768287
Name:SUMMERS, ERIKA RAE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:RAE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:590 STAGECOACH RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6129
Mailing Address - Country:US
Mailing Address - Phone:505-994-4759
Mailing Address - Fax:505-268-0184
Practice Address - Street 1:4210 LOUISIANA BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1807
Practice Address - Country:US
Practice Address - Phone:505-268-5933
Practice Address - Fax:505-268-0184
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3971235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist