Doctor Name: | MIRANDA KNIGHT |
NPI Number: | 1154735579 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 414154391 |
Business Practice Address: | 237 Eaton Corners Rd Delanson, NY - 120534901 |
Business Phone Number: | 5182076310 |
Business Fax Number: | |
Mailing Address: | 237 Eaton Corners Rd, DELANSON |
State: | NY |
Postal Code: | 120534901 |
Phone Number: | 5182076310 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 06/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 414154391 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |