Basic Information
| Provider Information | |||||||||
| NPI: | 1124046289 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURELL | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1156 LINCOLN AVE | ||||||||
| Address2: | |||||||||
| City: | BLAKELY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184471022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153799979 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 FOXCARE DR STE 103 | ||||||||
| Address2: | |||||||||
| City: | ONEONTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138202681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6074315757 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 020327-1 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.