Provider Demographics
NPI:1003875576
Name:KNOX, KATHERINE ELIZABETH (MA LLPC)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:KNOX
Suffix:
Gender:F
Credentials:MA LLPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1219 MINNESOTA ROAD
Mailing Address - Street 2:#138
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060
Mailing Address - Country:US
Mailing Address - Phone:810-388-1181
Mailing Address - Fax:
Practice Address - Street 1:1322 NORTH RIVER RAOD
Practice Address - Street 2:NORSERV GROUP
Practice Address - City:ST CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079
Practice Address - Country:US
Practice Address - Phone:810-329-4798
Practice Address - Fax:810-329-7303
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401007817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional