Provider Demographics
NPI:1952737959
Name:TURNER, TANESHA TABITHA
Entity Type:Individual
Prefix:
First Name:TANESHA
Middle Name:TABITHA
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 1:60 BROOKLEDGE ST
Mailing Address - Street 2:APT. 1H
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-2244
Mailing Address - Country:US
Mailing Address - Phone:857-205-1193
Mailing Address - Fax:
Practice Address - Street 1:60 BROOKLEDGE ST
Practice Address - Street 2:APT. 1H
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-2244
Practice Address - Country:US
Practice Address - Phone:857-205-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor