Provider Demographics
NPI:1780924969
Name:KNOX, DENISE ANASTASIA (MS)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANASTASIA
Last Name:KNOX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 MEDFORD PL
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-5942
Mailing Address - Country:US
Mailing Address - Phone:517-428-9317
Mailing Address - Fax:
Practice Address - Street 1:2180 MARAVILLA LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7221
Practice Address - Country:US
Practice Address - Phone:517-428-9317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health