MEDICARE: MS. KAREN ANNE KNAB MFT

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	106H00000X	Marriage & Family Therapist	83026	CA
2	106H00000X	Marriage & Family Therapist	4571	MN
3	106H00000X	Marriage & Family Therapist	001354-01	NY

General Provider Information

NPI Number	:	1952790685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN ANNE KNAB MFT

Provider Business Mailing Address
First Line	:	2216 IRVING AVE S APT 2
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2523
Country	:	US
Telephone Number	:	562-480-3595
Fax Number	:

Provider Business Practice Location Address
First Line	:	2216 IRVING AVE S APT 2
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2523
Country	:	US
Telephone Number	:	716-220-8125
Fax Number	:

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

Provider Enumeration Date	:	01/19/2015
Last Update Date	:	10/13/2024

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