MEDICARE: PAULA F KNOX LPC

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	101YP2500X	Professional Counselor	4551	OK

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	:	1528392339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA F KNOX LPC

Provider Business Mailing Address
First Line	:	PO BOX 57
Second Line	:
City	:	CARNEY
State	:	OK
Zip	:	74832-0057
Country	:	US
Telephone Number	:	405-865-2929
Fax Number	:	405-865-2930

Provider Business Practice Location Address
First Line	:	210 WEST CENTRAL
Second Line	:
City	:	CARNEY
State	:	OK
Zip	:	74832-0057
Country	:	US
Telephone Number	:	405-865-2929
Fax Number	:	405-865-2930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2009
Last Update Date	:	10/04/2012

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