Provider Demographics
NPI:1174254379
Name:SIMONE-KNAPP, GINA (MASTERS)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SIMONE-KNAPP
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:SIMONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTERS
Mailing Address - Street 1:42 ADDISON RD
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1439
Mailing Address - Country:US
Mailing Address - Phone:917-880-9615
Mailing Address - Fax:
Practice Address - Street 1:42 ADDISON RD
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1439
Practice Address - Country:US
Practice Address - Phone:917-880-9615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool