Provider Demographics
NPI:1497973655
Name:TURLEY, JEANNIE CAROL (MSP)
Entity Type:Individual
Prefix:MS
First Name:JEANNIE
Middle Name:CAROL
Last Name:TURLEY
Suffix:
Gender:F
Credentials:MSP
Other - Prefix:MS
Other - First Name:JEANNIE
Other - Middle Name:CAROL
Other - Last Name:TURLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSP
Mailing Address - Street 1:4501 OLD SPARTANBURG RD STE 7
Mailing Address - Street 2:EASTSIDE PROFESSIONAL COURT
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4105
Mailing Address - Country:US
Mailing Address - Phone:864-292-5154
Mailing Address - Fax:864-292-5154
Practice Address - Street 1:4501 OLD SPARTANBURG RD STE 7
Practice Address - Street 2:EASTSIDE PROFESSIONAL COURT
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4105
Practice Address - Country:US
Practice Address - Phone:864-292-5154
Practice Address - Fax:864-292-5154
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC383235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist