| NPI | 1154964757 |
|---|---|
| Former Name | SHADONNA ROSHAWN BANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN 1619) |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2025-11-19 |