Provider Demographics
NPI:1558672352
Name:BANKS, LINDSEY WILLIS (AU D)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:WILLIS
Last Name:BANKS
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MEGAN
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1360 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-9066
Mailing Address - Country:US
Mailing Address - Phone:941-488-2020
Mailing Address - Fax:941-484-2200
Practice Address - Street 1:1360 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-9066
Practice Address - Country:US
Practice Address - Phone:941-488-2020
Practice Address - Fax:941-484-2200
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1612231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist