Provider Demographics
NPI:1023482718
Name:OZTURK, AYBALA (LSW)
Entity type:Individual
Prefix:
First Name:AYBALA
Middle Name:
Last Name:OZTURK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N 16TH ST
Mailing Address - Street 2:APT T
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3423
Mailing Address - Country:US
Mailing Address - Phone:573-639-0202
Mailing Address - Fax:
Practice Address - Street 1:602 N 16TH ST
Practice Address - Street 2:APT T
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3423
Practice Address - Country:US
Practice Address - Phone:573-639-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132785104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker