Provider Demographics
NPI:1922659168
Name:STASO, SUMMER CLAIRE (MS, CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:CLAIRE
Last Name:STASO
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22932 S PEMBROOK. DR.
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636
Mailing Address - Country:US
Mailing Address - Phone:301-290-0800
Mailing Address - Fax:301-290-1313
Practice Address - Street 1:29770 THREE NOTCH ROAD, SUITE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622
Practice Address - Country:US
Practice Address - Phone:301-290-0800
Practice Address - Fax:301-290-1313
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01851L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist