Individual
MRS. TWYLA JANE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD,CCC-SLP
Contact information
Practice address
2808 FOX MEADOW LN, JONESBORO, AR 72404-9346
(870) 932-4245
Mailing address
3305 LONOKE CV, JONESBORO, AR 72404-9678
(870) 933-7213
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1133
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y642
AR BCBS PROVIDER #
AR
Enumeration date
01/23/2007
Last updated
07/09/2007
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