Provider Demographics
NPI:1053824946
Name:KNIGHTON, SUGCORA
Entity Type:Individual
Prefix:MISS
First Name:SUGCORA
Middle Name:
Last Name:KNIGHTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28391 LONGFELLOW LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:LA
Mailing Address - Zip Code:70711-4242
Mailing Address - Country:US
Mailing Address - Phone:225-771-9521
Mailing Address - Fax:
Practice Address - Street 1:28391 LONGFELLOW LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:LA
Practice Address - Zip Code:70711-4242
Practice Address - Country:US
Practice Address - Phone:225-771-9521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-14
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional