Provider Demographics
NPI:1063271716
Name:BANKS-GRIFFIN, TEANGELA MICHELLE (PLPC)
Entity type:Individual
Prefix:MRS
First Name:TEANGELA
Middle Name:MICHELLE
Last Name:BANKS-GRIFFIN
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:TEANGELA
Other - Middle Name:MICHELLE
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 TORERO LN
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-4372
Mailing Address - Country:US
Mailing Address - Phone:314-683-8510
Mailing Address - Fax:
Practice Address - Street 1:825 TORERO LN
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-4372
Practice Address - Country:US
Practice Address - Phone:314-683-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty