Healthcare Provider Details

I. General information

NPI: 1609790682
Provider Name (Legal Business Name): SAMANTHA TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CARRIAGE LN STE B
CHARLESTON SC
29407-6010
US

IV. Provider business mailing address

148 DIPLOMA DR
LADSON SC
29456-5326
US

V. Phone/Fax

Practice location:
  • Phone: 843-297-8470
  • Fax:
Mailing address:
  • Phone: 843-830-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: