MEDICARE: STACEY TURNER

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1194161034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY TURNER

Provider Business Mailing Address
First Line	:	2024 CARVER
Second Line	:
City	:	NORTHLASVEGAS
State	:	NV
Zip	:	89032-7697
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 W. CHEYENNE
Second Line	:
City	:	NLV
State	:	NV
Zip	:	89032-7697
Country	:	US
Telephone Number	:	702-868-2905
Fax Number	:

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

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	05/20/2013

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Directions to “ STACEY TURNER ” Practice Location

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