Provider Demographics
NPI:1467555391
Name:KNIGHT, VICTORIA JEAN (LMFT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JEAN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:JEAN
Other - Last Name:WOHNOWTKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:204 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-2805
Mailing Address - Country:US
Mailing Address - Phone:320-295-1263
Mailing Address - Fax:
Practice Address - Street 1:414 N 3RD ST STE 17
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-2466
Practice Address - Country:US
Practice Address - Phone:320-295-1263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076675106H00000X
MN1294106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
39763OtherHEALTH PARTNERS
MN968167100Medicaid
MN25D88KNOtherBCBS