Provider Demographics
NPI:1578944542
Name:KNOWLTON, LANEY ELIZABETH (LMFT)
Entity Type:Individual
Prefix:
First Name:LANEY
Middle Name:ELIZABETH
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LANEY
Other - Middle Name:
Other - Last Name:ALICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2785 ROCKBROOK DR STE 206
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5251
Mailing Address - Country:US
Mailing Address - Phone:682-216-6523
Mailing Address - Fax:
Practice Address - Street 1:2785 ROCKBROOK DR STE 206
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5251
Practice Address - Country:US
Practice Address - Phone:682-216-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist