Healthcare Provider Details

I. General information

NPI: 1760453955
Provider Name (Legal Business Name): RONALD L TURNER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 GLEN WILD RD
ROCK HILL NY
12775-6721
US

IV. Provider business mailing address

PO BOX 572
ROCK HILL NY
12775-0572
US

V. Phone/Fax

Practice location:
  • Phone: 845-707-9216
  • Fax:
Mailing address:
  • Phone: 845-707-9216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number011019
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number011019
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number011019
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number011019
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: