Provider Demographics
NPI:1003164435
Name:BANKS, JOSETTE VICTORIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSETTE
Middle Name:VICTORIA
Last Name:BANKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1731
Mailing Address - Country:US
Mailing Address - Phone:917-309-3305
Mailing Address - Fax:
Practice Address - Street 1:369 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2626
Practice Address - Country:US
Practice Address - Phone:917-309-3305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015591103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical