Provider Demographics
NPI:1740007269
Name:BANJO, AMINAT (PMHNP)
Entity type:Individual
Prefix:
First Name:AMINAT
Middle Name:
Last Name:BANJO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1190 W DRUID HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2121
Mailing Address - Country:US
Mailing Address - Phone:470-666-5736
Mailing Address - Fax:
Practice Address - Street 1:1190 W DRUID HILLS DR NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2121
Practice Address - Country:US
Practice Address - Phone:470-666-5736
Practice Address - Fax:678-550-9633
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN2882442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry