Organization
MONTGOMERY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORTNEY MARIE BANKS MS, LPC (MENTAL HEALTH THERAPIST)
(937) 457-2870
Entity
Organization
Contact information
Practice address
580 CALUMET LN, DAYTON, OH 45417-8014
(937) 457-2700
Mailing address
160 COPPERFIELD DR, DAYTON, OH 45415-1263
(937) 475-1734
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C.1001000
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5700012
—
OH
Enumeration date
04/06/2016
Last updated
04/06/2016
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