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Individual
KASSIE L MCKNIGHT
Active
Individual
KASSIE L MCKNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055475256
MEDICAID
MI
Enumeration date
04/21/2022
Last updated
05/04/2022
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