Kalani Azariah Banks
Individual provider Active NPI Psychologist · Highland, MI
NPI 1104656305 · NPPES record last updated Aug 3, 2024
Key facts
- NPI
- 1104656305
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- 210 W Highland Rd Ste 102
Highland, MI 48357-4573 - Phone
- (248) 529-3167
- NPI assigned
- Aug 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Yes |
Addresses
Primary practice location
210 W Highland Rd Ste 102
Highland, MI 48357-4573
Mailing address
52A Wedgewoode LN Apt 52a
Pontiac, MI 48340-2276
Phone (248) 205-6354
Other providers in Highland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.