Provider Demographics
NPI:1932535887
Name:MCKNIGHT, DELORIS ANN (EDD)
Entity Type:Individual
Prefix:MRS
First Name:DELORIS
Middle Name:ANN
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 EAST EVANS STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506
Mailing Address - Country:US
Mailing Address - Phone:843-676-9400
Mailing Address - Fax:
Practice Address - Street 1:181 EAST EVANS STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506
Practice Address - Country:US
Practice Address - Phone:843-676-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health