Provider Demographics
NPI:1730451113
Name:KNOX, CECILIA GAYNAIL BEATRICE
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:GAYNAIL BEATRICE
Last Name:KNOX
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 1:3924 SE 14TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-2230
Mailing Address - Country:US
Mailing Address - Phone:405-250-4453
Mailing Address - Fax:
Practice Address - Street 1:214 SW 30TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-6506
Practice Address - Country:US
Practice Address - Phone:405-272-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health