Provider Demographics
NPI:1194902775
Name:BANKS, BARBARA LEE (COTA/L)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:BANKS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3114
Mailing Address - Country:US
Mailing Address - Phone:843-363-5373
Mailing Address - Fax:843-363-5383
Practice Address - Street 1:16 EVERGREEN LN
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3114
Practice Address - Country:US
Practice Address - Phone:843-363-5373
Practice Address - Fax:843-363-5383
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2531224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant