Provider Demographics
NPI:1013279157
Name:KNIGHT, JEANNA RUFET (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JEANNA
Middle Name:RUFET
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 PALESTRA DRIVE
Mailing Address - Street 2:APT. 3
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146
Mailing Address - Country:US
Mailing Address - Phone:317-508-6942
Mailing Address - Fax:
Practice Address - Street 1:2173 PALESTRA DRIVE
Practice Address - Street 2:APT. 3
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:317-508-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012007232101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional