| Doctor Name: | MRS. MARY-BLAKE HARBIN SUMMERLIN |
| NPI Number: | 1942505516 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. |
| License Number: | DX3157 |
| Business Practice Address: | 24035 Three Notch Rd Hollywood, MD - 206364871 |
| Business Phone Number: | 3013737900 |
| Business Fax Number: | |
| Mailing Address: | 23256 Wild Daisy Way, CALIFORNIA |
| State: | MD |
| Postal Code: | 206194186 |
| Phone Number: | 4104124994 |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2011 |
| NPI Last Update Date: | 01/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DX3157 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |