Provider Demographics
NPI:1588717359
Name:KNIGHT, GABE BUDDYLEE (SA1)
Entity type:Individual
Prefix:MR
First Name:GABE
Middle Name:BUDDYLEE
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:SA1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:49515 MICHAEL AVE
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-1510
Mailing Address - Country:US
Mailing Address - Phone:661-822-8223
Mailing Address - Fax:661-823-9347
Practice Address - Street 1:113 E F ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-1710
Practice Address - Country:US
Practice Address - Phone:661-822-8223
Practice Address - Fax:661-823-9347
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)