MEDICARE: TENESHA 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	104100000X	Social Worker

General Provider Information

NPI Number	:	1235501131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENESHA TURNER

Provider Business Mailing Address
First Line	:	4824 CAMELLIA LN
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-5402
Country	:	US
Telephone Number	:	318-348-4764
Fax Number	:

Provider Business Practice Location Address
First Line	:	4824 CAMELLIA LN
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-5402
Country	:	US
Telephone Number	:	318-348-4764
Fax Number	:

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

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	10/30/2015

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Directions to “ TENESHA TURNER ” Practice Location

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