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General NPI Number Information
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NPI Number | 1548974595
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Entity Type | Individual
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Provider Name | BRIANNA RENEE BANKS
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Gender | Female
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 106 SOUTHPARK DR STE C
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City | BLACKSBURG
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State | VA
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Zip | 24060-6809
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Country | US
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Telephone | 571-934-3936
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Fax |
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Provider Business Mailing Address
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Address Line | 1086 THE LAKE RD
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City | CLINTWOOD
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State | VA
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Zip | 24228-7042
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Country | US
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Telephone | 276-207-1869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0704014789
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0704014789
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License Number State | VA
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