Individual
MRS. DEBRA KNICOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA ATR-BC LCAT
Contact information
Practice address
1274 FOX GAP RD, BANGOR, PA 18013-6004
(610) 588-0313
(610) 588-0319
Mailing address
1274 FOX GAP RD, BANGOR, PA 18013-6004
(610) 588-0313
(610) 588-0319
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
000396-1
NY
Other
Enumeration date
02/20/2007
Last updated
12/21/2012
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