Healthcare Provider Details

I. General information

NPI: 1891939807
Provider Name (Legal Business Name): ELIZABETH YEAGER TURNER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 ROSWELL RD SUITE 210
MARIETTA GA
30062-8809
US

IV. Provider business mailing address

3901 ROSWELL RD SUITE 210
MARIETTA GA
30062-8809
US

V. Phone/Fax

Practice location:
  • Phone: 770-509-8266
  • Fax: 770-509-8966
Mailing address:
  • Phone: 770-509-8266
  • Fax: 770-509-8966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY001912
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY001912
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: