Provider Demographics
NPI:1699597401
Name:KNIGHT, HARVARD ELISE
Entity type:Individual
Prefix:
First Name:HARVARD
Middle Name:ELISE
Last Name:KNIGHT
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 N ANKENY BLVD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4723
Mailing Address - Country:US
Mailing Address - Phone:515-446-2080
Mailing Address - Fax:
Practice Address - Street 1:2405 N ANKENY BLVD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4723
Practice Address - Country:US
Practice Address - Phone:515-446-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician