La'Dazia Sumler
Behavior Technician in Bridgeport, MI. Individual provider (NPI-1).
NPI number1669129409
StatusActive
Last updated in NPPESMar 2, 2022
Details
- NPI
- 1669129409
- Entity type
- Individual (NPI-1)
- Name
- La'Dazia Sumler
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 2, 2022
- Certification date
- Feb 17, 2022
- Last updated
- Mar 2, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
6296 Village Square Drive, Suite 2Bridgeport, MI 48722
Phone 989-401-1239
Mailing address
5039 Villa Linde Pkwy Ste 30Flint, MI 48532-3450
Phone 989-401-2244
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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