Provider Demographics
NPI:1477179331
Name:KNIGHT, BONITA MARIE
Entity Type:Individual
Prefix:
First Name:BONITA
Middle Name:MARIE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BONITA
Other - Middle Name:MARIE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3133 ASHLYN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15204-1705
Mailing Address - Country:US
Mailing Address - Phone:412-689-7921
Mailing Address - Fax:
Practice Address - Street 1:3133 ASHLYN ST APT 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15204-1705
Practice Address - Country:US
Practice Address - Phone:412-689-7921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician