Provider Demographics
NPI:1962135780
Name:KNIGHT, MELISSA DELORIS
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:DELORIS
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 SUWANEE DAM RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8702
Mailing Address - Country:US
Mailing Address - Phone:404-477-4954
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD STE 310
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8702
Practice Address - Country:US
Practice Address - Phone:404-477-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty