Individual
AMY MARIE BANKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
635 MAPLE AVE, DU BOIS, PA 15801-2376
(814) 375-6379
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6340
(814) 372-2560
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PC004621
PA
101YP2500X
Professional Counselor
Primary
PC004621
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002140882
HIGHMARK
—
05
—
1026173340001
—
PA
Enumeration date
07/02/2007
Last updated
03/30/2015
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