Provider Demographics
NPI:1821125782
Name:TURNER, JUDITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MASSACHUSETTS AVE
Mailing Address - Street 2:APARTMENT 202
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-3505
Mailing Address - Country:US
Mailing Address - Phone:847-920-9686
Mailing Address - Fax:
Practice Address - Street 1:255 MASSACHUSETTS AVE
Practice Address - Street 2:APARTMENT 202
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-3505
Practice Address - Country:US
Practice Address - Phone:847-920-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6330103TC0700X
IL071-006414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK16432Medicare PIN