Provider Demographics
NPI:1518236074
Name:BANKER, ROSE ANITA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANITA
Last Name:BANKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11603 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8914
Mailing Address - Country:US
Mailing Address - Phone:832-515-7301
Mailing Address - Fax:
Practice Address - Street 1:11603 SPRING CYPRESS RD
Practice Address - Street 2:SUITE B
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8914
Practice Address - Country:US
Practice Address - Phone:832-515-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical