Healthcare Provider Details

I. General information

NPI: 1114976701
Provider Name (Legal Business Name): SUMMIT PSYCHOLOGICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 N BROADWAY ST
AKRON OH
44308-1910
US

IV. Provider business mailing address

37 N BROADWAY ST
AKRON OH
44308-1910
US

V. Phone/Fax

Practice location:
  • Phone: 330-535-8181
  • Fax: 330-535-9336
Mailing address:
  • Phone: 330-535-8181
  • Fax: 330-535-9336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0529
License Number StateOH

VIII. Authorized Official

Name: MRS. RACHEL E. WADE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 330-535-8181