Provider Demographics
NPI:1831404763
Name:KNIGHT, JENNIFER LYNN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26946 SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-4511
Mailing Address - Country:US
Mailing Address - Phone:480-427-1325
Mailing Address - Fax:
Practice Address - Street 1:26946 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:OK
Practice Address - Zip Code:73093-4511
Practice Address - Country:US
Practice Address - Phone:480-427-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6885235Z00000X
OK4139235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist