Provider Demographics
NPI:1639219447
Name:BANKS, EMALEE COON (MED, MFT)
Entity Type:Individual
Prefix:MRS
First Name:EMALEE
Middle Name:COON
Last Name:BANKS
Suffix:
Gender:F
Credentials:MED, MFT
Other - Prefix:MISS
Other - First Name:EMALEE
Other - Middle Name:
Other - Last Name:COON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 987
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-0987
Mailing Address - Country:US
Mailing Address - Phone:801-860-1106
Mailing Address - Fax:
Practice Address - Street 1:94 E PAGES LN
Practice Address - Street 2:#A
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-2216
Practice Address - Country:US
Practice Address - Phone:801-294-0578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6437871-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist