Provider Demographics
NPI:1043616147
Name:TURNER, GINA
Entity Type:Individual
Prefix:
First Name:GINA
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 1:1144 S 73RD EAST AVE
Mailing Address - Street 2:APARTMENT 9
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-5731
Mailing Address - Country:US
Mailing Address - Phone:918-344-0190
Mailing Address - Fax:
Practice Address - Street 1:1144 S 73RD EAST AVE
Practice Address - Street 2:APARTMENT 9
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-5731
Practice Address - Country:US
Practice Address - Phone:918-344-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health