Provider Demographics
NPI:1427180157
Name:KNIGHT, DEBORAH L (LAT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 VALIANT LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-9135
Mailing Address - Country:US
Mailing Address - Phone:504-460-1718
Mailing Address - Fax:
Practice Address - Street 1:112 VALIANT LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-9135
Practice Address - Country:US
Practice Address - Phone:504-460-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAJ000732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer