Provider Demographics
NPI:1053785121
Name:TURNER, MAMIE (BCBA)
Entity type:Individual
Prefix:
First Name:MAMIE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27313-0158
Mailing Address - Country:US
Mailing Address - Phone:336-542-3772
Mailing Address - Fax:336-645-7051
Practice Address - Street 1:5202 OLDE FOREST DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406
Practice Address - Country:US
Practice Address - Phone:336-542-3772
Practice Address - Fax:336-645-7051
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst