Individual
TINA BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMSW
Contact information
Practice address
2411 W MAIN ST, JACKSONVILLE, AR 72076-4211
(501) 982-5402
(501) 553-6378
Mailing address
PO BOX 647, JACKSONVILLE, AR 72078-0647
(501) 982-5402
(501) 553-6378
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/13/2011
Last updated
06/21/2013
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