Provider Demographics
NPI:1154077428
Name:KNAUB, JAYME (LSW)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:
Last Name:KNAUB
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 GRANDVIEW RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9134
Mailing Address - Country:US
Mailing Address - Phone:717-969-8894
Mailing Address - Fax:717-620-4316
Practice Address - Street 1:3130 GRANDVIEW RD UNIT 4
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9134
Practice Address - Country:US
Practice Address - Phone:717-969-8894
Practice Address - Fax:717-620-4316
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134212104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker