Healthcare Provider Details

I. General information

NPI: 1962910612
Provider Name (Legal Business Name): SNOW COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COMANCHE RD NE STE 13
ALBUQUERQUE NM
87107-4546
US

IV. Provider business mailing address

PO BOX 174
ALBUQUERQUE NM
87103-0174
US

V. Phone/Fax

Practice location:
  • Phone: 505-203-8029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARA SNOW
Title or Position: OWNER
Credential:
Phone: 505-203-8029