Individual
MR. CHARLES ALAN BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
3950 BRISTOL HWY, JOHNSON CITY, TN 37601-1378
(423) 283-6500
(423) 286-6550
Mailing address
2311 ABBOTT DR. #2, JOHNSON CITY, TN 37601-9012
(423) 737-0653
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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