Provider Demographics
NPI:1902614696
Name:TURNER, VIVIANA GOR'NESE
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:GOR'NESE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-4608
Mailing Address - Country:US
Mailing Address - Phone:913-240-2126
Mailing Address - Fax:
Practice Address - Street 1:35 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-4608
Practice Address - Country:US
Practice Address - Phone:913-240-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst