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General NPI Number Information
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NPI Number | 1891506440
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Entity Type | Organization
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Legal Business Name | KNOX ACADEMY, LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 404 W PAULDING RD
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City | ELLISVILLE
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State | MS
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Zip | 39437-5083
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Country | US
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Telephone | 601-800-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SAINT AMBER DR
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City | ELLISVILLE
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State | MS
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Zip | 39437-8768
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Country | US
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Telephone | 601-800-4000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE GILLILAND
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Credential |
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Telephone | 601-577-2363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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