Basic Information
| Provider Information | |||||||||
| NPI: | 1467923706 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BANKS-SHERER | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 W COUNTY ROAD 6 | ||||||||
| Address2: | |||||||||
| City: | TIFFIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448838954 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 ST LAWRENCE DR | ||||||||
| Address2: | |||||||||
| City: | TIFFIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448838310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194557000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2018 | ||||||||
| LastUpdateDate: | 05/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | COND.2018600-SP | OH | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SP.13468 | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.