Individual
SAMUEL EDWARD BANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
406 WOODFIELD ST SW, HARTSELLE, AL 35640-6003
(909) 336-3330
Mailing address
PO BOX 6300, CRESTLINE, CA 92325-6300
(909) 336-3330
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
88964
CA
Other
Enumeration date
05/02/2019
Last updated
10/17/2022
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