Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1013040740 |
---|---|
Provider Name | Barbara Knight |
First Address | Santa Rosa, CA 95405-7575 |
Second Address | Santa Rosa, CA 95405-7575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 15/07/2014 |