Provider Demographics
NPI:1154476646
Name:KNELL ACCESS MANAGEMENT
Entity Type:Organization
Organization Name:KNELL ACCESS MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-332-7415
Mailing Address - Street 1:2 HICKERSON ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9759
Mailing Address - Country:US
Mailing Address - Phone:307-332-7415
Mailing Address - Fax:307-335-7116
Practice Address - Street 1:2 HICKERSON ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-9759
Practice Address - Country:US
Practice Address - Phone:307-332-7415
Practice Address - Fax:307-335-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY251B00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services