Individual provider · Type 1 NPI
Kimberley Yvonne Banta, LPC
Mental Health Counselor · Fort Eisenhower, GA
NPI number
1811548803
Active
Practice location
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Mailing address
3994 Madison Ln
Augusta, GA 30909-9215
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LPC010936 (GA) |
Mental Health Counselor: Definition to come...
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About NPI 1811548803
Kimberley Yvonne Banta, LPC's National Provider Identifier is 1811548803, issued on Sep 22, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Eisenhower, GA. The record was last updated on Dec 20, 2023.