Provider Demographics
NPI:1770270928
Name:KNOWLEDGE, KYASIA (MSW)
Entity type:Individual
Prefix:
First Name:KYASIA
Middle Name:
Last Name:KNOWLEDGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S PENNEWELL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-3315
Mailing Address - Country:US
Mailing Address - Phone:718-810-1488
Mailing Address - Fax:
Practice Address - Street 1:5211 AUTH RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4339
Practice Address - Country:US
Practice Address - Phone:202-257-6632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor