Individual
MRS. SUE BANISTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
5350 POPLAR AVE, SUITE 730, MEMPHIS, TN 38119-3699
(901) 683-5658
(901) 684-1277
Mailing address
5350 POPLAR AVE, SUITE 730, MEMPHIS, TN 38119-3699
(901) 683-5658
(901) 684-1277
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
L.P.C. 404
TN
Other
Enumeration date
10/18/2005
Last updated
07/08/2007
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