Provider Demographics
NPI:1861507527
Name:TURNER, TONI (MCD CCC SLP)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:MCD CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14702 GRAYWOOD GROVE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2108
Mailing Address - Country:US
Mailing Address - Phone:281-642-2700
Mailing Address - Fax:281-535-1346
Practice Address - Street 1:3027 MARINA BAY DR
Practice Address - Street 2:#105
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2729
Practice Address - Country:US
Practice Address - Phone:281-642-2700
Practice Address - Fax:281-535-1346
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14896235Z00000X
FLSA6728235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBCBS 87550TOtherSPEECH LANGUAGE PATHOLOGY