Provider Demographics
NPI:1346378064
Name:KNIGHT, MARINA (MS)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 BELL RD APT 121
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-8007
Mailing Address - Country:US
Mailing Address - Phone:954-560-2135
Mailing Address - Fax:615-298-6657
Practice Address - Street 1:1450 14TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3005
Practice Address - Country:US
Practice Address - Phone:615-460-1257
Practice Address - Fax:615-298-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional