Provider Demographics
NPI:1619737277
Name:KNOX, SHIRLEE ANN
Entity Type:Individual
Prefix:
First Name:SHIRLEE
Middle Name:ANN
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9198A THRALL RD
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-9329
Mailing Address - Country:US
Mailing Address - Phone:715-439-4377
Mailing Address - Fax:715-439-4388
Practice Address - Street 1:9198A THRALL RD
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568-9329
Practice Address - Country:US
Practice Address - Phone:715-439-4377
Practice Address - Fax:715-439-4388
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)