Provider Demographics
NPI:1366243057
Name:DOOLEY KNIGHT, MARTEZ
Entity type:Individual
Prefix:
First Name:MARTEZ
Middle Name:
Last Name:DOOLEY KNIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 BRIDLEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:OBETZ
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2312 BRIDLEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:OBETZ
Practice Address - State:OH
Practice Address - Zip Code:43207-4501
Practice Address - Country:US
Practice Address - Phone:614-432-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker