Provider Demographics
NPI:1497773691
Name:KNIGHT, GINA S (MS)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:S
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MABON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1412
Mailing Address - Country:US
Mailing Address - Phone:814-849-4906
Mailing Address - Fax:814-849-2322
Practice Address - Street 1:115 MABON ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1412
Practice Address - Country:US
Practice Address - Phone:814-849-4906
Practice Address - Fax:814-849-2322
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002119101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional