Individual
DR. WALTER PIERCE KNAKE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3659 S. GREEN RD., SUITE 119, BEACHWOOD, OH 44122-5715
(216) 831-0056
(216) 831-5804
Mailing address
19801 SUSSEX RD, SHAKER HEIGHTS, OH 44122-4916
(216) 561-1726
(216) 831-5804
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
164
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0538967
—
OH
01
—
BWC 341493791-00
CLINICAL PSYCHOLOGIST
OH
01
—
MAGELLAN 27059000
CLINICAL PSYCHOLOGIST
OH
Enumeration date
05/31/2005
Last updated
10/31/2011
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