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General NPI Number Information
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NPI Number | 1124380977
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Entity Type | Individual
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Provider Name | AMANDA L SUMMERS LPC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 1215 CROSSROADS BLVD.
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City | NORMAN
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State | OK
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Zip | 73072
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Country | US
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Telephone | 405-361-4524
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Fax | 405-701-8531
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Provider Business Mailing Address
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Address Line | 911 DAHLIA LANE
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City | NOBLE
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State | OK
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Zip | 73068
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Country | US
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Telephone | 405-361-4524
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Fax | 405-701-8531
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5194
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License Number State | OK
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