Niaza Knowles I
Counselor, Mental Health in Wellington, FL. Individual provider (NPI-1).
NPI number1275161978
StatusActive
Last updated in NPPESMar 30, 2020
Details
- NPI
- 1275161978
- Entity type
- Individual (NPI-1)
- Name
- Niaza Knowles I
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 29, 2020
- Certification date
- Mar 30, 2020
- Last updated
- Mar 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | IMH19289 | FL | Yes |
| 101YP2500X | Counselor, Professional | IMH19289 | FL | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | IMH19289 | FL |
Other names
- Nye Knowles (Professional Name)
Practice location
2062 Polo Gardens Dr Apt 107Wellington, FL 33414-2008
Phone 561-660-0654
Mailing address
2062 Polo Gardens Dr Apt 107Wellington, FL 33414-2008
Phone 561-660-0654
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