Healthcare Provider Details

I. General information

NPI: 1649669219
Provider Name (Legal Business Name): HEATHER YVONNE SNAPP LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N MAIN ST
WICHITA KS
67203-3609
US

IV. Provider business mailing address

PO BOX 670
WICHITA KS
67201-0670
US

V. Phone/Fax

Practice location:
  • Phone: 316-269-4160
  • Fax: 316-269-3550
Mailing address:
  • Phone: 316-469-4160
  • Fax: 316-269-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9460
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: