Provider Demographics
NPI:1083302665
Name:TURNBACH, TYLER MATTHEW
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:MATTHEW
Last Name:TURNBACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 W CHATHAM ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3169
Mailing Address - Country:US
Mailing Address - Phone:919-705-0668
Mailing Address - Fax:
Practice Address - Street 1:956 W CHATHAM ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3169
Practice Address - Country:US
Practice Address - Phone:919-705-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician