Provider Demographics
NPI:1043527393
Name:KNAPP, DEIRDRE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7754 SUNDEW DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7557
Mailing Address - Country:US
Mailing Address - Phone:561-200-0964
Mailing Address - Fax:
Practice Address - Street 1:7754 SUNDEW DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-7557
Practice Address - Country:US
Practice Address - Phone:561-200-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL PY 7986103TC0700X
FLPY 7986103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLII082ZMedicare Oscar/Certification