Provider Demographics
NPI:1013499920
Name:SUMMITT, TORI ADRIANNA (SLP)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:ADRIANNA
Last Name:SUMMITT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 LINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4077
Mailing Address - Country:US
Mailing Address - Phone:870-520-8761
Mailing Address - Fax:870-573-8133
Practice Address - Street 1:146 LINWOOD DR
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4077
Practice Address - Country:US
Practice Address - Phone:870-520-8761
Practice Address - Fax:870-573-8133
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR222Q00000X, 235Z00000X
AR1801802355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARSLPA-180180OtherSPEECH THERAPY ASSISTANT CERTIFICATION- ADE