Provider Demographics
NPI:1700467891
Name:KNAUP, KATHERINE MAY (EDS)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAY
Last Name:KNAUP
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 CHAMBERLAIN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-2932
Mailing Address - Country:US
Mailing Address - Phone:314-276-7511
Mailing Address - Fax:
Practice Address - Street 1:1223 N KINGSHIGHWAY ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-3506
Practice Address - Country:US
Practice Address - Phone:573-271-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor