Doctor Name: | KEISHA BANKS |
NPI Number: | 1740346949 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLP005833 |
Business Practice Address: | 108 S Highway 135 Ste A Lakeland, GA - 316356356 |
Business Phone Number: | 2295601135 |
Business Fax Number: | |
Mailing Address: | Po Box 431, LAKELAND |
State: | GA |
Postal Code: | 316350431 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 06/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP005833 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |