Provider Demographics
NPI:1891066114
Name:MCKNIGHT, DEANN
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 WAIMANO HOME RD
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1478
Mailing Address - Country:US
Mailing Address - Phone:808-454-1411
Mailing Address - Fax:808-454-0659
Practice Address - Street 1:2501 WAIMANO HOME RD
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1478
Practice Address - Country:US
Practice Address - Phone:808-454-1411
Practice Address - Fax:808-454-0659
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health