Provider Demographics
NPI:1588914139
Name:KNOWLES, RICHARD THOMAS (MA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:THOMAS
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4546 EL CAMINO REAL STE B7
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1069
Mailing Address - Country:US
Mailing Address - Phone:866-362-4246
Mailing Address - Fax:650-260-6030
Practice Address - Street 1:4546 EL CAMINO REAL STE B7
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1069
Practice Address - Country:US
Practice Address - Phone:866-362-4246
Practice Address - Fax:650-260-6030
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health