Provider Demographics
NPI:1760757405
Name:KNEIPP, LEE B (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:B
Last Name:KNEIPP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-4612
Mailing Address - Country:US
Mailing Address - Phone:318-542-9805
Mailing Address - Fax:
Practice Address - Street 1:311 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-4612
Practice Address - Country:US
Practice Address - Phone:318-542-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1169103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist