Healthcare Provider Details

I. General information

NPI: 1912245895
Provider Name (Legal Business Name): NASHAE M TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

IV. Provider business mailing address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

V. Phone/Fax

Practice location:
  • Phone: 936-633-5672
  • Fax: 936-633-5695
Mailing address:
  • Phone: 936-633-5672
  • Fax: 936-633-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number67200
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: