Provider Demographics
NPI:1629375076
Name:SUMMERS, CLAUDIA MAE (LMBT)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:MAE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3459
Mailing Address - Country:US
Mailing Address - Phone:828-413-1766
Mailing Address - Fax:
Practice Address - Street 1:119 W UNION ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3459
Practice Address - Country:US
Practice Address - Phone:828-413-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8796225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist