Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003231929 |
---|---|
Provider Name | Devora Knight |
First Address | Baton Rouge, LA 70806-6506 |
Second Address | Baton Rouge, LA 70806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2014 |
Last Update Date | 11/06/2018 |