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NPI Code Detail

MEDICARE: SUMMER BARE

MEDICARE: SUMMER BARE
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 AnalystNC

General Provider Information

NPI Number : 1760054738
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUMMER BARE
Provider Business Mailing Address
First Line : 6201 FAIRVIEW RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3297
Country : US
Telephone Number : 980-317-8260
Fax Number :
Provider Business Practice Location Address
First Line : 6201 FAIRVIEW RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3297
Country : US
Telephone Number : 980-317-8260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2021
Last Update Date : 03/31/2026

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Directions to “ SUMMER BARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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