Individual
MISSY BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1908 S 14TH ST, PHOENIX, AZ 85034-0501
(937) 232-3154
Mailing address
1908 S 14TH ST, PHOENIX, AZ 85034-0501
(937) 232-3154
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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