Provider Demographics
NPI:1184319089
Name:SUMMERS, REGINIA R
Entity type:Individual
Prefix:MS
First Name:REGINIA
Middle Name:R
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:REGINIA
Other - Middle Name:R
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3707 4H STREET SE
Mailing Address - Street 2:APT F
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032
Mailing Address - Country:US
Mailing Address - Phone:202-790-1799
Mailing Address - Fax:
Practice Address - Street 1:3300 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2408
Practice Address - Country:US
Practice Address - Phone:202-878-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health