Doctor Name: | JERRY O KNAPKE |
NPI Number: | 1265600985 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | C-0005149 |
Business Practice Address: | 7695 S County Road 25a Tipp City, OH - 453719215 |
Business Phone Number: | 9376674678 |
Business Fax Number: | 9376674963 |
Mailing Address: | 7695 S County Road 25a, TIPP CITY |
State: | OH |
Postal Code: | 453719215 |
Phone Number: | 9376674678 |
Fax Number: | 9376674963 |
NPI Enumeration Date: | 02/15/2008 |
NPI Last Update Date: | 02/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | C-0005149 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |