Healthcare Provider Details

I. General information

NPI: 1124366877
Provider Name (Legal Business Name): ELLYN TURER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2013
Last Update Date: 01/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 18TH ST NW
WASHINGTON DC
20036-6516
US

IV. Provider business mailing address

1327 18TH ST NW
WASHINGTON DC
20036-6516
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-2400
  • Fax: 202-452-1853
Mailing address:
  • Phone: 202-785-2400
  • Fax: 202-452-1853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000844
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: