Provider Demographics
NPI:1336665637
Name:KNOX, DOROTHY E (MED)
Entity Type:Individual
Prefix:PROF
First Name:DOROTHY
Middle Name:E
Last Name:KNOX
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PROFESSOR KNOX
Mailing Address - Street 1:46 BROOKLEY RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46 BROOKLEY RD
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3627
Practice Address - Country:US
Practice Address - Phone:617-799-0106
Practice Address - Fax:617-799-0106
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health