Provider Demographics
NPI:1689946220
Name:KNIGHT, CRYSTAL M (MA)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-8446
Mailing Address - Country:US
Mailing Address - Phone:304-237-2897
Mailing Address - Fax:
Practice Address - Street 1:213 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-8446
Practice Address - Country:US
Practice Address - Phone:304-237-2897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency