Provider Demographics
NPI:1356017115
Name:SUMMERS, AARON
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 APPALOOSA LN APT 5114
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-5038
Mailing Address - Country:US
Mailing Address - Phone:478-919-8568
Mailing Address - Fax:
Practice Address - Street 1:4562 LAWRENCEVILLE HWY NW STE 101B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3650
Practice Address - Country:US
Practice Address - Phone:678-630-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist