Provider Demographics
NPI:1235596644
Name:KORTE-TURNBULL, MARY KATHRYN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHRYN
Last Name:KORTE-TURNBULL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:KORTE-TURNBULL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:2750 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6179
Mailing Address - Country:US
Mailing Address - Phone:734-769-8196
Mailing Address - Fax:
Practice Address - Street 1:2750 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6179
Practice Address - Country:US
Practice Address - Phone:734-769-8196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM1203261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical