Individual
LINDA T BANISAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5257 BIG TYLER RD, CROSS LANES, WV 25313-1839
(681) 217-1121
Mailing address
5257 BIG TYLER RD, CROSS LANES, WV 25313-1839
(304) 823-2937
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00945543
WV
Other
Enumeration date
07/03/2020
Last updated
07/03/2020
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