MEDICARE: MS. MARIJA COLIC-TURCINOV M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1134549843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIJA COLIC-TURCINOV M.A.

Provider Business Mailing Address
First Line	:	10770 COTTAGE HILL LN
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-9762
Country	:	US
Telephone Number	:	216-523-8498
Fax Number	:	216-523-6309

Provider Business Practice Location Address
First Line	:	10770 COTTAGE HILL LN
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-9762
Country	:	US
Telephone Number	:	216-544-7555
Fax Number	:	216-523-6309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2014
Last Update Date	:	04/21/2014

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