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Individual
MS. JAN DENEAN BANISTER
Active
Individual
MS. JAN DENEAN BANISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LPC/S
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC3524
SC
101YM0800X
Mental Health Counselor
Primary
3524
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1336
—
SC
Enumeration date
12/20/2006
Last updated
09/10/2019
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