Provider Demographics
NPI:1588825533
Name:TURNER, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:TURNER
Suffix:
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 1:106 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:S ROYALTON
Mailing Address - State:VT
Mailing Address - Zip Code:05068-5118
Mailing Address - Country:US
Mailing Address - Phone:802-763-5270
Mailing Address - Fax:603-650-0678
Practice Address - Street 1:106 BROWN RD
Practice Address - Street 2:
Practice Address - City:S ROYALTON
Practice Address - State:VT
Practice Address - Zip Code:05068-5118
Practice Address - Country:US
Practice Address - Phone:802-763-5270
Practice Address - Fax:603-650-0678
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0585235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist