Individual
MS. TARA BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
306 CHURCH ST, PORT GIBSON, MS 39150-2108
(601) 437-5504
(601) 437-5505
Mailing address
306 CHURCH ST, PORT GIBSON, MS 39150-2108
(601) 437-5504
(601) 437-5506
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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