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General NPI Number Information
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NPI Number | 1366627259
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Entity Type | Individual
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Provider Name | KATHLEEN EVELAND TURNER LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 319 N TIOGA ST
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City | ITHACA
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State | NY
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Zip | 14850-4205
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Country | US
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Telephone | 607-257-5039
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Fax | 607-257-5039
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Provider Business Mailing Address
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Address Line | 132 BURLEIGH DR
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City | ITHACA
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State | NY
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Zip | 14850-1744
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Country | US
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Telephone | 607-257-9957
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Fax | 607-257-9957
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 056245
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License Number State | NY
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