| NPI | 1528804523 |
|---|---|
| Professional Name | THOMAS BANTA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001744A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 88001398A) |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |