Provider Demographics
NPI:1104915693
Name:KNIGHT, CHRISTIANNE
Entity type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AVA
Other - Middle Name:CHRISTIANNE
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:405 18TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 3RD AVE SW
Practice Address - Street 2:SUITE D
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4346
Practice Address - Country:US
Practice Address - Phone:701-852-3328
Practice Address - Fax:701-838-2521
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND486-1-1-03101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health