Knickerbocker, Maria J

Knickerbocker, Maria J is an individual health care provider with primary practice located at 118 College Dr # 5163 , Hattiesburg MS 39406-0001. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Knickerbocker, Maria J can be contacted via phone (601) 266-5163.

Contact Information

Primary practice address
118 College Dr # 5163 Hattiesburg MS 39406-0001
Phone: (601) 266-5163
Fax: (601) 266-5114
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C6975 Mississippi

Profile Details

NPI number 1689863359
LBN Legal business name Knickerbocker, Maria J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2007
Last updated Oct 18th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689863359 NPPES
Mississippi MEDICAID 00675504

Popular Providers