Healthcare Provider Details

I. General information

NPI: 1174931182
Provider Name (Legal Business Name): GLORIA TURNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SE 2ND ST
PENDLETON OR
97801-2224
US

IV. Provider business mailing address

1101 I AVE
LA GRANDE OR
97850-2043
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-6207
  • Fax:
Mailing address:
  • Phone: 541-963-6715
  • Fax: 541-962-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7247
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW36364
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: