Provider Demographics
NPI:1336278027
Name:BANKS, ELKE CHRISTINE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ELKE
Middle Name:CHRISTINE
Last Name:BANKS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 AVENIDA DE LA LUNA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1606
Mailing Address - Country:US
Mailing Address - Phone:505-821-4593
Mailing Address - Fax:505-821-3124
Practice Address - Street 1:9712 AVENIDA DE LA LUNA NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1606
Practice Address - Country:US
Practice Address - Phone:505-821-4593
Practice Address - Fax:505-821-3124
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM587225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics