Provider Demographics
NPI:1598725079
Name:TURNER, MARCIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCIE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 11729
Mailing Address - Street 2:943 CESERY BOULEVARD, BUILDING G
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32239-1729
Mailing Address - Country:US
Mailing Address - Phone:904-745-3111
Mailing Address - Fax:904-745-3131
Practice Address - Street 1:943 CESERY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5655
Practice Address - Country:US
Practice Address - Phone:904-745-3111
Practice Address - Fax:904-745-3131
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
75283Medicare ID - Type Unspecified