Provider Demographics
NPI:1295480481
Name:WILLIAMS-KNOX, LISA (M ED)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WILLIAMS-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:POST OFFICE BOX 199
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017
Mailing Address - Country:US
Mailing Address - Phone:410-384-4153
Mailing Address - Fax:410-431-2818
Practice Address - Street 1:336 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 2B-A
Practice Address - City:BELAIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-384-4153
Practice Address - Fax:410-431-2818
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health