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NPI Code Detail

MEDICARE: SUMMER LARA ABDELFATTAH

MEDICARE: SUMMER LARA ABDELFATTAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2241TN

General Provider Information

NPI Number : 1467122333
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUMMER LARA ABDELFATTAH
Provider Business Mailing Address
First Line : 625 MORRISON SPRINGS RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-3401
Country : US
Telephone Number : 423-802-1982
Fax Number :
Provider Business Practice Location Address
First Line : 625 MORRISON SPRINGS RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-3401
Country : US
Telephone Number : 423-802-1982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2021
Last Update Date : 05/07/2026

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Directions to “ SUMMER LARA ABDELFATTAH ” Practice Location

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