Provider Demographics
NPI:1043507775
Name:TURNER, SHARONDA
Entity Type:Individual
Prefix:
First Name:SHARONDA
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 I 55 N
Mailing Address - Street 2:SUITE 291
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5930
Mailing Address - Country:US
Mailing Address - Phone:601-362-0859
Mailing Address - Fax:
Practice Address - Street 1:4500 I 55 N
Practice Address - Street 2:SUITE 291
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5930
Practice Address - Country:US
Practice Address - Phone:601-362-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist