| Dianna Banks Phd Llc | |
|
115 Farley Cir Ste 113 Lewisburg PA 17837-9252 | |
| (570) 238-0193 | |
| Not Available |
| Full Name | Dianna Banks Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 115 Farley Cir Ste 113, Lewisburg, Pennsylvania |
| Authorized Official Name and Position | Dianna Michelle Banks (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 5709390857 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dianna Banks Phd Llc 115 Farley Cir Ste 113 Lewisburg PA 17837-9252 Ph: (570) 238-0193 | Dianna Banks Phd Llc 115 Farley Cir Ste 113 Lewisburg PA 17837-9252 Ph: (570) 238-0193 |
| NPI Number | 1518451822 |
|---|---|
| Provider Enumeration Date | 06/20/2018 |
| Last Update Date | 12/23/2023 |
| Certification Date | 12/23/2023 |
| Medicare PECOS PAC ID | 4284981721 |
|---|---|
| Medicare Enrollment ID | O20180716001403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518451822 | NPI | - | NPPES |
| 1063753549 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS017290 (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Dianna Michelle Banks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063753549 PECOS PAC ID: 6507093812 Enrollment ID: I20131212000565 |
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