MEDICARE: MRS. LISA 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	235Z00000X	Speech-Language Pathologist		OH

General Provider Information

NPI Number	:	1619391596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA TURNER

Provider Business Mailing Address
First Line	:	120 FARR DR
Second Line	:
City	:	SPRINGBORO
State	:	OH
Zip	:	45066-8653
Country	:	US
Telephone Number	:	937-825-6356
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 OLD HARSHMAN RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45431-1238
Country	:	US
Telephone Number	:	937-259-6640
Fax Number	:

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

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/12/2014

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Directions to “ MRS. LISA TURNER ” Practice Location

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