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General NPI Number Information
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NPI Number | 1902292089
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Entity Type | Organization
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Legal Business Name | WORAWAN TURNER PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 4021 VERNON AVE S SUITE 212
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2801
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Country | US
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Telephone | 952-222-4491
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Fax |
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Provider Business Mailing Address
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Address Line | 4021 VERNON AVE S STE 212
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2801
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Country | US
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Telephone | 952-222-4491
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Fax | 952-222-4492
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Authorized Official
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Title or Position | OWNER
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Name | WORAWAN C TURNER
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Credential |
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Telephone | 612-423-5244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LP4984
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License Number State | MN
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