Provider Demographics
NPI:1972299717
Name:TUREAUD, ED'LONDA JANAY
Entity Type:Individual
Prefix:
First Name:ED'LONDA
Middle Name:JANAY
Last Name:TUREAUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PINE KNOLL DR APT 254
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1355
Mailing Address - Country:US
Mailing Address - Phone:601-337-9190
Mailing Address - Fax:
Practice Address - Street 1:1935 LAKELAND DR STE 900
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5028
Practice Address - Country:US
Practice Address - Phone:601-589-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health