Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701002635 | VA |
NPI | 1003846601 |
---|---|
Provider Name | Mr. Robert Turner |
First Address | Spotsylvania, VA 22553-7600 |
Second Address | Spotsylvania, VA 22553-2002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
082769 | SENTARA (01) | VA |
261789 | MDIPA (01) | VA |
272608 | ANTHEM (01) | VA |
4945123 | (05) | VA |