Provider Demographics
NPI:1821369315
Name:TURNER, TERRY LEE (MA)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LEE
Last Name:TURNER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3540
Mailing Address - Country:US
Mailing Address - Phone:727-547-0607
Mailing Address - Fax:727-547-6742
Practice Address - Street 1:4425 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3540
Practice Address - Country:US
Practice Address - Phone:727-547-0607
Practice Address - Fax:727-547-6742
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health