MR. Mark Cody Banta, LPC U/S, CADC
NPI #1013138965 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1013138965
- Entity Type
- Individual
- Name
- MR. Mark Cody Banta, LPC U/S, CADC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- LPC U/S, CADC
- Enumeration Date
- May 1, 2007
- Last Updated
- Sep 1, 2009
Practice Location
- Address
- 3033 N WALNUT AVE
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73105-2832
- Phone
- (405) 230-1145
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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