Provider Demographics
NPI:1528392339
Name:KNOX, PAULA F (LPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:F
Last Name:KNOX
Suffix:
Gender:F
Credentials:LPC
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 57
Mailing Address - Street 2:
Mailing Address - City:CARNEY
Mailing Address - State:OK
Mailing Address - Zip Code:74832-0057
Mailing Address - Country:US
Mailing Address - Phone:405-865-2929
Mailing Address - Fax:405-865-2930
Practice Address - Street 1:210 WEST CENTRAL
Practice Address - Street 2:
Practice Address - City:CARNEY
Practice Address - State:OK
Practice Address - Zip Code:74832-0057
Practice Address - Country:US
Practice Address - Phone:405-865-2929
Practice Address - Fax:405-865-2930
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746170UMedicaid