Individual
HEATHER BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1465 OAKFIELD DR, BRANDON, FL 33511-4854
(813) 438-8748
Mailing address
PO BOX 126, LITHIA, FL 33547-0126
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4640
FL
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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