Provider Demographics
NPI:1790273670
Name:BANKINS, KATRINA BROWN (CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:BROWN
Last Name:BANKINS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 GUENEVERE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2799
Mailing Address - Country:US
Mailing Address - Phone:757-558-5347
Mailing Address - Fax:
Practice Address - Street 1:2901 GUENEVERE DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2799
Practice Address - Country:US
Practice Address - Phone:757-558-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist