Provider Demographics
NPI:1033233309
Name:KNABEL, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:KNABEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:IN
Mailing Address - Zip Code:47918-1617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 SUZIE LN
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:IN
Practice Address - Zip Code:47918-2009
Practice Address - Country:US
Practice Address - Phone:765-762-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000224A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical