Provider Demographics
NPI:1205093267
Name:KNOX, VIRGINIA HARRIS (M ED)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:HARRIS
Last Name:KNOX
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CHAMBERLAIN CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-3158
Mailing Address - Country:US
Mailing Address - Phone:336-317-9089
Mailing Address - Fax:
Practice Address - Street 1:104 CHAMBERLAIN CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-3158
Practice Address - Country:US
Practice Address - Phone:336-317-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional