Tara Banks, BSW

Individual provider Active NPI Social Worker · Port Gibson, MS

NPI 1760040547 · NPPES record last updated Jun 5, 2019

Key facts

NPI
1760040547
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
Practice address
306 Church St
Port Gibson, MS 39150-2108
Phone
(601) 437-5504
Fax
(601) 437-5505
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

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)CodeLicenseStatePrimary
Social Worker 104100000X Yes

Addresses

Primary practice location

306 Church St
Port Gibson, MS 39150-2108

Mailing address

306 Church St
Port Gibson, MS 39150-2108
Phone (601) 437-5504

Other providers in Port Gibson, MS

All providers in Port Gibson, MS · Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.