Provider Demographics
NPI:1508012832
Name:TURCOTTE, EDITH A (LICENSED CLINICAL SW)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:A
Last Name:TURCOTTE
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 E FORT LOWELL RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2301
Mailing Address - Country:US
Mailing Address - Phone:520-275-0968
Mailing Address - Fax:
Practice Address - Street 1:1735 E FORT LOWELL RD
Practice Address - Street 2:SUITE 11
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2301
Practice Address - Country:US
Practice Address - Phone:520-275-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 106091041C0700X
FLSW 54851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical