Provider Demographics
NPI:1821460205
Name:MCKNIGHT, VERONICA NATALIA (MSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:NATALIA
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:NATALIA
Other - Last Name:KIESERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1712 CALVADOS DR
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-5781
Mailing Address - Country:US
Mailing Address - Phone:516-376-5513
Mailing Address - Fax:
Practice Address - Street 1:1712 CALVADOS DR
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-5781
Practice Address - Country:US
Practice Address - Phone:516-376-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical