Individual
LINDA LOUISE BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3702 E BETHEL LN, BLOOMINGTON, IN 47408-9011
(317) 902-8079
Mailing address
3702 E BETHEL LN, BLOOMINGTON, IN 47408-9011
(317) 902-8079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003545A
IN
Other
Enumeration date
09/09/2019
Last updated
12/27/2023
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