Provider Demographics
NPI:1770057077
Name:SUMMER, DEY KUEMPEL (LMT)
Entity type:Individual
Prefix:MS
First Name:DEY
Middle Name:KUEMPEL
Last Name:SUMMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:JANE
Other - Last Name:KUEMPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:393 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6701
Mailing Address - Country:US
Mailing Address - Phone:339-368-0163
Mailing Address - Fax:
Practice Address - Street 1:393 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6701
Practice Address - Country:US
Practice Address - Phone:339-368-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4008OtherMASSACHUSETTS THERAPEUTIC MASSAGE LICENSE