Provider Demographics
NPI:1487470035
Name:TURNEY, ASPEN BLISS (LAC)
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:BLISS
Last Name:TURNEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 W BASELINE RD UNIT 1004
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5759
Mailing Address - Country:US
Mailing Address - Phone:623-258-9726
Mailing Address - Fax:
Practice Address - Street 1:1645 W BASELINE RD UNIT 1004
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5759
Practice Address - Country:US
Practice Address - Phone:623-258-9726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22984101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health