Individual
AZZIZA BANKOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW STE 302, ROANOKE, VA 24014-2465
(540) 981-7653
(540) 981-7469
Mailing address
2001 CRYSTAL SPRING AVE SW STE 302, ROANOKE, VA 24014-2465
(540) 981-7653
(540) 981-7469
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101245202
VA
Other
Enumeration date
07/09/2008
Last updated
12/18/2018
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