Provider Demographics
NPI:1245355635
Name:SUMERFORD, DANETTE (CFY-SLP)
Entity type:Individual
Prefix:MS
First Name:DANETTE
Middle Name:
Last Name:SUMERFORD
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5457
Mailing Address - Country:US
Mailing Address - Phone:515-965-7682
Mailing Address - Fax:515-963-9125
Practice Address - Street 1:301 NE TRILEIN DR STE 4
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2170
Practice Address - Country:US
Practice Address - Phone:515-965-7682
Practice Address - Fax:515-963-9125
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01726T235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist