Doctor Name: | MR. ALTON MCKNIGHT |
NPI Number: | 1710918669 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 156 |
Business Practice Address: | 2520 Line Ave Shreveport, LA - 711043022 |
Business Phone Number: | 3182226226 |
Business Fax Number: | 3182218526 |
Mailing Address: | 2520 Line Ave, SHREVEPORT |
State: | LA |
Postal Code: | 711043022 |
Phone Number: | 3182226226 |
Fax Number: | 3182218526 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | 156 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |