Provider Demographics
NPI:1346690997
Name:TURNER, KYLAN SARA (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:KYLAN
Middle Name:SARA
Last Name:TURNER
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E PORTLAND ST
Mailing Address - Street 2:UNIT 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1972
Mailing Address - Country:US
Mailing Address - Phone:480-322-5638
Mailing Address - Fax:
Practice Address - Street 1:615 E PORTLAND ST
Practice Address - Street 2:UNIT 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1972
Practice Address - Country:US
Practice Address - Phone:480-322-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ217103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst