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Individual

KRISTEN BANISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1601 N TUCSON BLVD, TUCSON, AZ 85716-3425
(928) 225-1845
Mailing address
619 N 9TH AVE, TUCSON, AZ 85705-8340
(928) 225-1845

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17056
AZ

Other

Enumeration date
07/09/2018
Last updated
07/09/2018
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