Individual
ANNA MICHELLE HAVENS BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STA
Contact information
Practice address
5507 SW 9TH AVENUE, AMARILLO, TX 79106
(806) 468-7611
(806) 468-7603
Mailing address
5507 SW 9TH AVENUE, AMARILLO, TX 79106
(806) 468-7611
(806) 468-7603
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
0217267-01
TX
2355S0801X
Speech-Language Assistant
34253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217267-01
—
TX
Enumeration date
06/19/2008
Last updated
07/25/2018
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