Provider Demographics
NPI:1649280884
Name:KNISLEY, TONI M (BHRS, CM)
Entity type:Individual
Prefix:MS
First Name:TONI
Middle Name:M
Last Name:KNISLEY
Suffix:
Gender:F
Credentials:BHRS, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-9118
Mailing Address - Country:US
Mailing Address - Phone:580-323-6021
Mailing Address - Fax:580-331-2007
Practice Address - Street 1:100 N 31ST ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-9118
Practice Address - Country:US
Practice Address - Phone:580-323-6021
Practice Address - Fax:580-331-2007
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator