Individual
MRS. CAROL ANN BANKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1008 CLAIRE RD, MONTOURSVILLE, PA 17754-1112
(570) 368-1624
Mailing address
1008 CLAIRE RD, MONTOURSVILLE, PA 17754-1112
(570) 368-1624
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL000998L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001926904-0004
—
PA
Enumeration date
03/18/2007
Last updated
07/09/2007
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