Provider Demographics
NPI:1659688505
Name:KNIGHT, CECILIA HIBBARD (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:HIBBARD
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S MARION ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2826
Mailing Address - Country:US
Mailing Address - Phone:708-358-3000
Mailing Address - Fax:708-524-0300
Practice Address - Street 1:115 S MARION ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2826
Practice Address - Country:US
Practice Address - Phone:708-358-3000
Practice Address - Fax:708-524-0300
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-04-1867 (BCBA)103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst