Provider Demographics
NPI:1376224816
Name:GRIFFIN, SUMMER BROOK (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:BROOK
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 N CLOVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3615
Mailing Address - Country:US
Mailing Address - Phone:928-699-7937
Mailing Address - Fax:
Practice Address - Street 1:3844 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3308
Practice Address - Country:US
Practice Address - Phone:520-477-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP13859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist