Healthcare Provider Details

I. General information

NPI: 1164718714
Provider Name (Legal Business Name): HEIDI SNITCHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 ANDREWS DR
NORFOLK NE
68701-2760
US

IV. Provider business mailing address

PO BOX 1163
NORFOLK NE
68702-1163
US

V. Phone/Fax

Practice location:
  • Phone: 402-851-4026
  • Fax: 402-379-2487
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2958
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: