Provider Demographics
NPI:1710232079
Name:TURELL, MARTHA ISABEL
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ISABEL
Last Name:TURELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:M
Other - Middle Name:ISABEL
Other - Last Name:TURELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:6927 WATERBROOK CT
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3924
Mailing Address - Country:US
Mailing Address - Phone:631-258-9425
Mailing Address - Fax:
Practice Address - Street 1:6927 WATERBROOK CT
Practice Address - Street 2:
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-3924
Practice Address - Country:US
Practice Address - Phone:631-258-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist