Mr. Christopher Joseph Banta
Rehabilitation Psychologist
218 Dividend Dr Ste 3
Rexburg
, Idaho 83440-3510
Mr. Christopher Joseph Banta
Rehabilitation Psychologist
218 Dividend Dr Ste 3
Rexburg
, Idaho 83440-3510
(208) 351-0149
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Mr. Christopher Joseph Banta
- 635 Angela Dr
- Rexburg, ID
- Zip : 83440-1422
- Phone : (208) 351-0149
Second Address
- Mr. Christopher Joseph Banta
- 218 Dividend Dr Ste 3
- Rexburg, ID
- Zip : 83440-3510
- Phone : (208) 359-9683
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1164545877 |
|---|---|
| Provider Name | Mr. Christopher Joseph Banta |
| First Address | Rexburg, ID 83440-1422 |
| Second Address | Rexburg, ID 83440-3510 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/04/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.