Provider Demographics
NPI:1356535785
Name:ISRAWI, SUMMER FOUSIEH (CCC SLP)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:FOUSIEH
Last Name:ISRAWI
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3407
Mailing Address - Country:US
Mailing Address - Phone:623-643-8877
Mailing Address - Fax:
Practice Address - Street 1:32 SPUR CIR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5461
Practice Address - Country:US
Practice Address - Phone:623-643-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist