Provider Demographics
NPI:1023024221
Name:TURNER, MICHELE BOWDEN (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:BOWDEN
Last Name:TURNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 MIDDLEBURG DR
Mailing Address - Street 2:STE 109
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2413
Mailing Address - Country:US
Mailing Address - Phone:803-936-7530
Mailing Address - Fax:803-936-7452
Practice Address - Street 1:2711 MIDDLEBURG DR
Practice Address - Street 2:STE 109
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2413
Practice Address - Country:US
Practice Address - Phone:803-936-7530
Practice Address - Fax:803-936-7452
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3829231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4644OtherMEDICAID GROUP NUMBER
SCSA0763Medicaid