Provider Demographics
NPI:1497476568
Name:KNOX, JANNA CHRISTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:CHRISTINE
Last Name:KNOX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2369 FM 2458
Mailing Address - Street 2:
Mailing Address - City:JUSTICEBURG
Mailing Address - State:TX
Mailing Address - Zip Code:79330-2521
Mailing Address - Country:US
Mailing Address - Phone:806-445-4094
Mailing Address - Fax:
Practice Address - Street 1:2369 FM 2458
Practice Address - Street 2:
Practice Address - City:JUSTICEBURG
Practice Address - State:TX
Practice Address - Zip Code:79330-2521
Practice Address - Country:US
Practice Address - Phone:806-445-4094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical