Provider Demographics
NPI:1952790685
Name:KNAB, KAREN ANNE (MFT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANNE
Last Name:KNAB
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 IRVING AVE S APT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2523
Mailing Address - Country:US
Mailing Address - Phone:562-480-3595
Mailing Address - Fax:
Practice Address - Street 1:2216 IRVING AVE S APT 2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2523
Practice Address - Country:US
Practice Address - Phone:716-220-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83026106H00000X
MN4571106H00000X
NY001354-01106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist