Healthcare Provider Details

I. General information

NPI: 1649647363
Provider Name (Legal Business Name): KATHERINE KNIGHT ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 EAGLE RIDGE DR
HURON OH
44839-1867
US

IV. Provider business mailing address

134 BENEDICT AVE
NORWALK OH
44857-2349
US

V. Phone/Fax

Practice location:
  • Phone: 440-225-1469
  • Fax:
Mailing address:
  • Phone: 419-660-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH1172909
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: