Provider Demographics
NPI:1790918654
Name:KNIFFEN, ERIN BRADSHAW (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:BRADSHAW
Last Name:KNIFFEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9735 LANDMARK PKWY
Mailing Address - Street 2:SUITE 17
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-842-6223
Mailing Address - Fax:314-842-6124
Practice Address - Street 1:9735 LANDMARK PARKWAY DR
Practice Address - Street 2:SUITE 17
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1646
Practice Address - Country:US
Practice Address - Phone:314-842-6223
Practice Address - Fax:314-842-6124
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007025814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional