MEDICARE: TONI MCKNABB

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1619816303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI MCKNABB

Provider Business Mailing Address
First Line	:	2102 PRAIRIE SONG LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-2620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 PRAIRIE SONG LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-2620
Country	:	US
Telephone Number	:	704-626-9436
Fax Number	:

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

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “ TONI MCKNABB ” Practice Location

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