Provider Demographics
NPI:1316452790
Name:KNOX, ERICA DEMETRIS (M ED, MS, MHP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DEMETRIS
Last Name:KNOX
Suffix:
Gender:F
Credentials:M ED, MS, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-0072
Mailing Address - Country:US
Mailing Address - Phone:318-649-6399
Mailing Address - Fax:318-649-2356
Practice Address - Street 1:6907 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418
Practice Address - Country:US
Practice Address - Phone:318-649-6399
Practice Address - Fax:318-649-2356
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator