Provider Demographics
NPI:1124721949
Name:KNOWLES, KENDALL RUTH (MA, PLPC)
Entity type:Individual
Prefix:MISS
First Name:KENDALL
Middle Name:RUTH
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 LAKE VILLA DR STE 301
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6710
Mailing Address - Country:US
Mailing Address - Phone:504-635-7162
Mailing Address - Fax:
Practice Address - Street 1:2750 LAKE VILLA DR STE 301
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6710
Practice Address - Country:US
Practice Address - Phone:504-635-7162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health