Doctor Name: | RICHARD MCKNIGHT |
NPI Number: | 1023269883 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 4098-125 |
Business Practice Address: | 20700 Watertown Rd Suite 102 Waukesha, WI - 531861800 |
Business Phone Number: | 2627821474 |
Business Fax Number: | 2627821441 |
Mailing Address: | 20700 Watertown Rd, Suite 102 WAUKESHA |
State: | WI |
Postal Code: | 531861800 |
Phone Number: | 2627821474 |
Fax Number: | 2627821441 |
NPI Enumeration Date: | 10/09/2008 |
NPI Last Update Date: | 10/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4098-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |