Provider Information for 1366916447
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CHELSEA BANKS MMFT, LCAS-A
Sex: Female
NPI: 1366916447
Last Updated: 2019-01-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1366916447 | ||||||||
| Enumeration Date | 2019-01-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1627 MARVELLE AVE ROCKY MOUNT, NC 27803-2328 United States Phone: 610-360-6802 | Fax: | ||||||||
| Primary Practice Address | 3208 SUNSET AVE STE B ROCKY MOUNT, NC 27804-3590 United States Phone: 252-212-5524 | Fax:252-212-5844 | ||||||||
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