Mike Knickerbocker, LADAC

NPI #1770847485 in Warren, Arkansas

Provider Information

NPI Number: 1770847485
Entity Type: Individual
Name: Mike Knickerbocker, LADAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LADAC
Enumeration Date: Jun 27, 2012
Last Updated: Jun 27, 2012

Practice Location

Address: 412 YORK ST
City: Warren
State: Arkansas
ZIP Code: 71671-3218
Phone: (870) 226-9970

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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