Doctor Name: | MRS. JEANNA RUFET KNIGHT |
NPI Number: | 1013279157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2012007232 |
Business Practice Address: | 2173 Palestra Drive Apt. 3 St. Louis, MO - 63146 |
Business Phone Number: | 3175086942 |
Business Fax Number: | |
Mailing Address: | 2173 Palestra Drive, Apt. 3 ST. LOUIS |
State: | MO |
Postal Code: | 63146 |
Phone Number: | 3175086942 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2012 |
NPI Last Update Date: | 06/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2012007232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |