Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401007817 | MI |
NPI | 1003875576 |
---|---|
Provider Name | Miss Katherine Elizabeth Knox |
First Address | Port Huron, MI 48060 |
Second Address | St Clair, MI 48079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 08/07/2007 |