Provider Demographics
NPI:1952937294
Name:KNIGHT, CARLA DENISE
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:DENISE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 SW 54TH TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-6024
Mailing Address - Country:US
Mailing Address - Phone:954-218-0772
Mailing Address - Fax:
Practice Address - Street 1:1640 SW 54TH TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-6024
Practice Address - Country:US
Practice Address - Phone:954-218-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor