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Individual

DR. DIANE M BANIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1219 TAYLORWOOD RD, SIMPSONVILLE, KY 40067
(502) 777-7339
Mailing address
1219 TAYLOR WOOD RD, SIMPSONVILLE, KY 40067-6635
(502) 777-7339

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0830
KY

Other

Enumeration date
04/24/2009
Last updated
04/24/2009
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