Provider Demographics
NPI:1740552314
Name:KNIGHTS, GENA MARIE (COTA, ADMINISTRATOR)
Entity type:Individual
Prefix:
First Name:GENA
Middle Name:MARIE
Last Name:KNIGHTS
Suffix:
Gender:F
Credentials:COTA, ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SLIPPERY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-2930
Mailing Address - Country:US
Mailing Address - Phone:724-406-0462
Mailing Address - Fax:
Practice Address - Street 1:600 SLIPPERY ROCK RD
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-2930
Practice Address - Country:US
Practice Address - Phone:724-406-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007171224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant