Basic Information
| Provider Information | |||||||||
| NPI: | 1417930413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | F. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MLSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5489 N SYCAMORE ST | ||||||||
| Address2: | |||||||||
| City: | BURTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485091350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107439942 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4001 N SAGINAW ST | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485053994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107875109 | ||||||||
| FaxNumber: | 8107899222 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801046702 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.