| NPI | 1083335244 |
|---|---|
| Former Name | STACY BANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-11-06 |