MEDICARE: DR. CRAIG W. KNAPP P.C.

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
1	103TC0700X	Clinical Psychologist	0480000261	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013231133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CRAIG W. KNAPP P.C.

Provider Business Mailing Address
First Line	:	PO BOX 218
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-0218
Country	:	US
Telephone Number	:	802-775-2728
Fax Number	:	802-775-2728

Provider Business Practice Location Address
First Line	:	646 NORTH SHREWSBURY RD
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-0218
Country	:	US
Telephone Number	:	802-775-2728
Fax Number	:	802-775-2728

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG WENDELL KNAPP
Credential	:	PH.D.
Telephone Number	:	802-775-2728

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	03/18/2010

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