Individual
RAYDESHA BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
849 WATERWORKS RD, WINSTON SALEM, NC 27101-1956
(336) 595-2166
Mailing address
4621 BAY CREEK DR, WINSTON SALEM, NC 27106-9422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11557
NC
Other
Enumeration date
03/03/2018
Last updated
03/17/2018
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