Provider Demographics
NPI:1275255564
Name:KNISPEL, DONNA J
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:KNISPEL
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 1:9658 SEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:MI
Mailing Address - Zip Code:48001-4384
Mailing Address - Country:US
Mailing Address - Phone:810-479-1921
Mailing Address - Fax:
Practice Address - Street 1:9658 SEAWAY DR
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:MI
Practice Address - Zip Code:48001-4384
Practice Address - Country:US
Practice Address - Phone:810-479-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst