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General NPI Number Information
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NPI Number | 1184964884
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Entity Type | Individual
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Provider Name | HOLLY N SUMMERS PHD
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Gender | Female
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 630 S RANCHO DR STE D
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City | LAS VEGAS
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State | NV
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Zip | 89106-4849
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Country | US
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Telephone | 702-409-4797
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Fax |
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Provider Business Mailing Address
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Address Line | 630 S RANCHO DR STE D
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City | LAS VEGAS
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State | NV
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Zip | 89106-4849
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Country | US
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Telephone | 702-409-4797
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY1170
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License Number State | NV
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