Provider Demographics
NPI:1134982671
Name:KNOCH, DEVON JODELLE
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:JODELLE
Last Name:KNOCH
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 1:1550 SHERIDAN DR STE 203
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1380
Mailing Address - Country:US
Mailing Address - Phone:740-901-3040
Mailing Address - Fax:
Practice Address - Street 1:1550 SHERIDAN DR STE 203
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1380
Practice Address - Country:US
Practice Address - Phone:740-901-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)