Provider Demographics
NPI:1780851527
Name:SEWELL, SUMMER (MS)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:
Last Name:SEWELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:NORPHLET
Mailing Address - State:AR
Mailing Address - Zip Code:71759-0050
Mailing Address - Country:US
Mailing Address - Phone:870-546-2751
Mailing Address - Fax:870-546-2345
Practice Address - Street 1:600 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:NORPHLET
Practice Address - State:AR
Practice Address - Zip Code:71759-0050
Practice Address - Country:US
Practice Address - Phone:870-546-2751
Practice Address - Fax:870-546-2345
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist