Provider Demographics
NPI:1649810037
Name:TURNER, KELSIE ALYSE
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:ALYSE
Last Name:TURNER
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 1:42 BRIARWOOD LN APT 8
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2520
Mailing Address - Country:US
Mailing Address - Phone:508-813-5086
Mailing Address - Fax:
Practice Address - Street 1:42 BRIARWOOD LN APT 8
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-2520
Practice Address - Country:US
Practice Address - Phone:508-813-5086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician