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Individual

MRS. LAURA JEAN BANKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RT

Contact information

Practice address
151 KNOLLCROFT RD # 117-D, LYONS, NJ 07939-5001
(908) 647-0180
Mailing address
151 KNOLLCROFT RD, 117D, LYONS, NJ 07939
(908) 647-0180

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
NJ

Other

Enumeration date
03/14/2008
Last updated
03/14/2008
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