Provider Demographics
NPI:1548673189
Name:TURNER, MALLORY NASH (MS, SLP)
Entity type:Individual
Prefix:MS
First Name:MALLORY
Middle Name:NASH
Last Name:TURNER
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 S JOPLIN LOOP
Mailing Address - Street 2:APT 1
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4539
Mailing Address - Country:US
Mailing Address - Phone:870-403-1719
Mailing Address - Fax:
Practice Address - Street 1:129 E POPLAR ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4212
Practice Address - Country:US
Practice Address - Phone:479-462-3528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist