Provider Demographics
NPI:1922243773
Name:KNIGHT, JOANN (CERTIFIED COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:CERTIFIED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 NW 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-2738
Mailing Address - Country:US
Mailing Address - Phone:954-260-6911
Mailing Address - Fax:
Practice Address - Street 1:2020 NW 31ST AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-2738
Practice Address - Country:US
Practice Address - Phone:954-260-6911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230603253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000314300Medicaid