Provider Demographics
NPI:1790121762
Name:TURNER, PHILLIP (MS)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 BETTYE ST
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-1701
Mailing Address - Country:US
Mailing Address - Phone:205-699-4781
Mailing Address - Fax:205-699-2148
Practice Address - Street 1:1704 BETTYE ST
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-1701
Practice Address - Country:US
Practice Address - Phone:205-699-4781
Practice Address - Fax:205-699-2148
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health