Individual
ERICA BANICKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
REAR 307 LAIRD ST, CHOICES RECOVERY PROGRAM, WILKES BARRE, PA 18702
(570) 408-9320
(570) 408-9324
Mailing address
REAR 307 LAIRD STREET, CHOICES PROGRAM OF WYOMING VALLEY, WILKES BARRE, PA 18702
(570) 408-9320
(570) 408-9324
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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