Provider Demographics
NPI:1932698990
Name:KNIGHT, RAYMOND ALBERT (PHD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ALBERT
Last Name:KNIGHT
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 1:37 MILL ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2720
Mailing Address - Country:US
Mailing Address - Phone:508-543-6784
Mailing Address - Fax:508-543-6784
Practice Address - Street 1:37 MILL ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2720
Practice Address - Country:US
Practice Address - Phone:508-543-6784
Practice Address - Fax:508-543-6784
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2469-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2469-PY-PROtherDIVISION OF PROFESSIONAL LICENSURE BOARD OD REGISTRATION OF PSYCHOLOGISTS