Provider Demographics
NPI:1811246374
Name:SUMMER, NETTI JO (PHD)
Entity type:Individual
Prefix:DR
First Name:NETTI
Middle Name:JO
Last Name:SUMMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 E CHERRY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-3573
Mailing Address - Country:US
Mailing Address - Phone:864-634-0937
Mailing Address - Fax:
Practice Address - Street 1:1330 E CHERRY ST STE 102
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-3573
Practice Address - Country:US
Practice Address - Phone:864-634-0937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014035928103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist