Individual
BRAD BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2108 MAGNOLIA LN, HILLSBOROUGH, NC 27278-9307
(919) 923-8687
Mailing address
2108 MAGNOLIA LN, HILLSBOROUGH, NC 27278-9307
(919) 923-8687
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007994
NC
Other
Enumeration date
01/11/2007
Last updated
07/24/2023
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