Larry Allen Bankston, CRPS, CAC

NPI #1588369482 in Pinellas Park, Florida

Provider Information

NPI Number: 1588369482
Entity Type: Individual
Name: Larry Allen Bankston, CRPS, CAC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Credential: CRPS, CAC
Enumeration Date: Apr 3, 2023
Last Updated: Apr 3, 2023

Practice Location

Address: 7114 79TH TER N # 139
City: Pinellas Park
State: Florida
ZIP Code: 33781-1918
Phone: (727) 421-2070

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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