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General NPI Number Information
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NPI Number | 1487054953
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Entity Type | Individual
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Provider Name | SUMMER WYERS MS, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 2907 W 108TH PL S
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City | JENKS
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State | OK
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Zip | 74037-2481
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Country | US
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Telephone | 918-212-4091
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 W 108TH PL S
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City | JENKS
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State | OK
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Zip | 74037-2481
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Country | US
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Telephone | 918-212-4091
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Fax | 918-960-9551
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6295
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License Number State | OK
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