Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1023109071 |
---|---|
Provider Name | Mr. Ernest Leonard Banks |
First Address | San Antonio, TX 78229-2258 |
Second Address | San Antonio, TX 78229-2258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |