Healthcare Provider Details

I. General information

NPI: 1043361157
Provider Name (Legal Business Name): JANICE KNAPP KNIGHT M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 CHAPMAN RD
MILLBROOK AL
36054-2513
US

IV. Provider business mailing address

4410 CHAPMAN RD
MILLBROOK AL
36054-2513
US

V. Phone/Fax

Practice location:
  • Phone: 334-546-9054
  • Fax: 334-285-8543
Mailing address:
  • Phone: 334-546-9054
  • Fax: 334-285-8543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number79
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: