Individual
FREDERICA MABEL BANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3431 CAMPBELL AVE APT A, HONOLULU, HI 96815-6120
(808) 436-1652
Mailing address
3431 CAMPBELL AVE APT A, HONOLULU, HI 96815-6120
(808) 436-1652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904000745
VA
1041C0700X
Clinical Social Worker
Primary
LCSW-4400
HI
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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