| NPI | 1477890531 |
|---|---|
| Former Name | THERESA M BANAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA CO161724L) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SC 7933) |
| 101YP2500X Counselor Professional (Licence: PA PC006724) | |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2022-04-12 |