Provider Demographics
NPI:1730726670
Name:BANKS, ALEXIS TATIANNA (BCBA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:TATIANNA
Last Name:BANKS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 RETREAT DR APT 103
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7877
Mailing Address - Country:US
Mailing Address - Phone:407-497-9548
Mailing Address - Fax:
Practice Address - Street 1:14611 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3219
Practice Address - Country:US
Practice Address - Phone:407-497-9548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst