Provider Demographics
NPI:1982310298
Name:TURMAN, GRAYCE
Entity Type:Individual
Prefix:
First Name:GRAYCE
Middle Name:
Last Name:TURMAN
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 1:1323 CAROLYN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-8101
Mailing Address - Country:US
Mailing Address - Phone:731-415-5151
Mailing Address - Fax:
Practice Address - Street 1:4055 N PARK LOOP OFC 1501
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38152-4220
Practice Address - Country:US
Practice Address - Phone:901-678-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-23-254389106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician