Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 015591 | NY |
Y | 103TC0700X | Clinical Psychologist | 015591 | NY |
NPI | 1003164435 |
---|---|
Provider Name | Dr. Josette Victoria Banks |
First Address | Yonkers, NY 10703-1731 |
Second Address | Dobbs Ferry, NY 10522-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2012 |
Last Update Date | 15/08/2012 |