Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | LA |
NPI | 1013446392 |
---|---|
Provider Name | Mrs. Charlotte Evette Turner |
First Address | Bossier City, LA 71111-5493 |
Second Address | Bossier City, LA 71111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 08/06/2017 |