Individual
SHANIEAH SIMONE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11361 W PEREGRINE WAY, GREENFIELD, WI 53228-3151
(414) 213-4956
Mailing address
11361 W PEREGRINE WAY, GREENFIELD, WI 53228-3151
(414) 213-4956
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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