Provider Demographics
NPI:1376688895
Name:KNOFF, KAREN ALICE (MA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ALICE
Last Name:KNOFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8333
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-0833
Mailing Address - Country:US
Mailing Address - Phone:208-892-0752
Mailing Address - Fax:
Practice Address - Street 1:505 S MOUNTAIN VIEW RD STE 2
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-9205
Practice Address - Country:US
Practice Address - Phone:208-301-0649
Practice Address - Fax:208-882-4774
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-3018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health