Provider Demographics
NPI:1366204141
Name:KNOBBE, MARY MARGARET (LMFT, ATR)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:KNOBBE
Suffix:
Gender:F
Credentials:LMFT, ATR
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:KNOBBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21380 CENTRE POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21380 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3050
Practice Address - Country:US
Practice Address - Phone:405-612-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141419106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist