Provider Demographics
NPI:1437388469
Name:KNIZEK, AMY (MED, LMHC, CRC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KNIZEK
Suffix:
Gender:F
Credentials:MED, LMHC, CRC
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 10013
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99209-1013
Mailing Address - Country:US
Mailing Address - Phone:509-570-4804
Mailing Address - Fax:509-242-3002
Practice Address - Street 1:1212 N WASHINGTON ST
Practice Address - Street 2:ONE ROCK POINTE, SUITE 306
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2403
Practice Address - Country:US
Practice Address - Phone:509-570-4804
Practice Address - Fax:509-796-5254
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-12
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60160750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional