Healthcare Provider Details

I. General information

NPI: 1396175162
Provider Name (Legal Business Name): THERESA LUCILLE EVANS KNIGHT MA, MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2013
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CRANBURY RD
NORWALK CT
06851-2616
US

IV. Provider business mailing address

37 CRANBURY RD
NORWALK CT
06851-2616
US

V. Phone/Fax

Practice location:
  • Phone: 203-722-7101
  • Fax: 203-849-3230
Mailing address:
  • Phone: 203-722-7101
  • Fax: 203-849-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: