Provider Demographics
NPI:1326534165
Name:KNIGHT, JUDITH VASHTI
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:VASHTI
Last Name:KNIGHT
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 1:10340 DEMOCRACY LN STE 102B
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2518
Mailing Address - Country:US
Mailing Address - Phone:571-386-0871
Mailing Address - Fax:
Practice Address - Street 1:9427 CANDLEBERRY CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3251
Practice Address - Country:US
Practice Address - Phone:202-615-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst