Provider Demographics
NPI:1104176221
Name:KNOBBE, NIM CLARA
Entity type:Individual
Prefix:
First Name:NIM
Middle Name:CLARA
Last Name:KNOBBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 N CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2218
Mailing Address - Country:US
Mailing Address - Phone:712-546-4624
Mailing Address - Fax:712-546-9395
Practice Address - Street 1:712 N CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2218
Practice Address - Country:US
Practice Address - Phone:712-546-4624
Practice Address - Fax:712-546-9395
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator