Provider Demographics
NPI:1083170468
Name:BANKS, LORRAINE HARRIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:HARRIS
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 1:11311 NEWPORT MILL RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1419
Mailing Address - Country:US
Mailing Address - Phone:301-929-2244
Mailing Address - Fax:
Practice Address - Street 1:5721 GROSVENOR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1833
Practice Address - Country:US
Practice Address - Phone:301-530-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist