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Individual
MISS LISA ANN BANNER
Active
Individual
MISS LISA ANN BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1800075791
IL
101YS0200X
School Counselor
2442773
IL
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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