Provider Demographics
NPI:1952103350
Name:MCKNIGHT, TAMARA N
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:N
Last Name:MCKNIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 CORAL AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-1670
Mailing Address - Country:US
Mailing Address - Phone:407-600-2305
Mailing Address - Fax:
Practice Address - Street 1:2520 CORAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-1670
Practice Address - Country:US
Practice Address - Phone:407-600-2305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator