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General NPI Number Information
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NPI Number | 1912604109
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Entity Type | Individual
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Provider Name | KIZZIE BANKS LPC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1751 OAK PLAINS RD
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City | ASHLAND CITY
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State | TN
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Zip | 37015-9113
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Country | US
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Telephone | 931-431-8155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1336
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City | OAK GROVE
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State | KY
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Zip | 42262-1336
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Country | US
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Telephone | 931-431-8155
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6481
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License Number State | TN
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