Provider Demographics
NPI:1295033561
Name:TURNER, AUDRY LYNN (MA)
Entity Type:Individual
Prefix:MS
First Name:AUDRY
Middle Name:LYNN
Last Name:TURNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30692 TANGLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1209
Mailing Address - Country:US
Mailing Address - Phone:313-218-8437
Mailing Address - Fax:
Practice Address - Street 1:30692 TANGLEWOOD TRL
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1209
Practice Address - Country:US
Practice Address - Phone:313-218-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional