Provider Demographics
NPI:1669524724
Name:TURNAGE, TAYLOR GIBBES (MCD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:GIBBES
Last Name:TURNAGE
Suffix:
Gender:F
Credentials:MCD, CCC-A
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:CONWAY
Other - Last Name:GIBBES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD, CCC-A
Mailing Address - Street 1:3981 COUNCIL CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-5812
Mailing Address - Country:US
Mailing Address - Phone:601-613-4843
Mailing Address - Fax:601-981-5530
Practice Address - Street 1:971 LAKELAND DR
Practice Address - Street 2:SUITE 854
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4643
Practice Address - Country:US
Practice Address - Phone:601-981-2825
Practice Address - Fax:601-981-5530
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA3125231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist