MEDICARE: MALLORY TURK

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		IL

General Provider Information

NPI Number	:	1699342667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORY TURK

Provider Business Mailing Address
First Line	:	107 CAYCE VALLEY DR
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-5101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 CAYCE VALLEY DR
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-5101
Country	:	US
Telephone Number	:	815-341-9711
Fax Number	:

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

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	04/10/2026

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Directions to “ MALLORY TURK ” Practice Location

Language	Start Address	Practice Location

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