Provider Demographics
NPI:1194469122
Name:TURNER, FREDERICK NELSON II
Entity Type:Individual
Prefix:MRS
First Name:FREDERICK
Middle Name:NELSON
Last Name:TURNER
Suffix:II
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 1:1417 SARATOGA AVE NE APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1923
Mailing Address - Country:US
Mailing Address - Phone:301-379-2894
Mailing Address - Fax:
Practice Address - Street 1:1417 SARATOGA AVE NE APT 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1923
Practice Address - Country:US
Practice Address - Phone:301-379-2894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB60034973103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty