Provider Demographics
NPI:1699413039
Name:LOWE, SUMMER DANIELLE
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:DANIELLE
Last Name:LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7781 OLD WIRE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28351-9085
Mailing Address - Country:US
Mailing Address - Phone:910-544-6166
Mailing Address - Fax:
Practice Address - Street 1:4929 DARCY WOODS LN
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-7622
Practice Address - Country:US
Practice Address - Phone:919-810-1459
Practice Address - Fax:919-400-4224
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty