Provider Demographics
NPI:1437325008
Name:SUMMERS, JULIE LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LYNN
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9 IRVINGDELL PL
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1222
Mailing Address - Country:US
Mailing Address - Phone:860-460-3475
Mailing Address - Fax:860-650-0010
Practice Address - Street 1:9 IRVINGDELL PL
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1222
Practice Address - Country:US
Practice Address - Phone:860-460-3475
Practice Address - Fax:860-650-0010
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist