Individual
LISANDRA JOSEPHINE HANNAH BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCLC
Contact information
Practice address
1724 FAIRVIEW AVE STE A, MISSOULA, MT 59801-7873
(406) 214-3810
Mailing address
2200 GARLAND DR APT 10, MISSOULA, MT 59803-2134
(765) 623-2033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-PCLC-LIC-63754
MT
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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