Provider Demographics
NPI:1871160812
Name:KNOX, SARA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:KNOX
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 TALL GRASS AVE
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:IA
Mailing Address - Zip Code:52340-4753
Mailing Address - Country:US
Mailing Address - Phone:319-775-0074
Mailing Address - Fax:319-774-6775
Practice Address - Street 1:1140 TALL GRASS AVE
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:IA
Practice Address - Zip Code:52340-4753
Practice Address - Country:US
Practice Address - Phone:319-775-0074
Practice Address - Fax:319-774-6775
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086607104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker