Provider Demographics
NPI:1366827016
Name:KNOCHEL, JULIANN
Entity Type:Individual
Prefix:
First Name:JULIANN
Middle Name:
Last Name:KNOCHEL
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 1:42325 ANN ARBOR RD E
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4356
Mailing Address - Country:US
Mailing Address - Phone:734-456-2026
Mailing Address - Fax:
Practice Address - Street 1:42325 ANN ARBOR RD E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4356
Practice Address - Country:US
Practice Address - Phone:734-456-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI6301016296103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other