Provider Demographics
NPI:1417161787
Name:TURNER, SUSAN DARNELL IV
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:DARNELL
Last Name:TURNER
Suffix:IV
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:STAFFORDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41256-0756
Mailing Address - Country:US
Mailing Address - Phone:606-478-9751
Mailing Address - Fax:
Practice Address - Street 1:256 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:BETSY LAYNE
Practice Address - State:KY
Practice Address - Zip Code:41605-0128
Practice Address - Country:US
Practice Address - Phone:606-478-9751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist