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NPI Code Detail

MEDICARE: YERINA KNOBLOCK MFT

MEDICARE: YERINA KNOBLOCK MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist47035CA
2106H00000XMarriage & Family Therapist001714GA

General Provider Information

NPI Number : 1134452899
Entity Type Code : Individual
Provider Name (Legal Business Name) : YERINA KNOBLOCK MFT
Provider Business Mailing Address
First Line : PO BOX 2404
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-0056
Country : US
Telephone Number : 949-289-1000
Fax Number :
Provider Business Practice Location Address
First Line : 5887 GLENRIDGE DR STE 230
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30328-9929
Country : US
Telephone Number : 949-289-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2009
Last Update Date : 03/26/2024

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Directions to “ YERINA KNOBLOCK MFT” Practice Location

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