Provider Demographics
NPI:1033645569
Name:BANKS, PAULINE (BS)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:BANKS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3553
Mailing Address - Country:US
Mailing Address - Phone:504-896-2345
Mailing Address - Fax:504-896-2240
Practice Address - Street 1:1538 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3553
Practice Address - Country:US
Practice Address - Phone:504-896-2345
Practice Address - Fax:504-896-2240
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor