Provider Demographics
NPI:1487245767
Name:TURNER, MAURA NICOLE (BS, RBT)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:NICOLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:BS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6234
Mailing Address - Country:US
Mailing Address - Phone:540-577-0551
Mailing Address - Fax:
Practice Address - Street 1:40 BETTY DR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1910
Practice Address - Country:US
Practice Address - Phone:540-577-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2023-08-08
Deactivation Date:2023-07-26
Deactivation Code:
Reactivation Date:2023-08-07
Provider Licenses
StateLicense IDTaxonomies
VARBT-21-152135106S00000X
VA0133003097103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician