Individual
KIMBERLY JEAN KNOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADC
Contact information
Practice address
1 JEFFERSON BARRACKS RD BLDG 51E, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 894-6664
Mailing address
1 JEFFERSON BARRACKS RD BLDG 51E, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 894-6664
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
016607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016607
LICENSED PROFESSIONAL COUNSELOR
IL
01
—
178.016607
LICENSED PROFESSIONAL COUNSELOR
IL
Enumeration date
10/11/2022
Last updated
10/11/2022
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