Healthcare Provider Details

I. General information

NPI: 1033830401
Provider Name (Legal Business Name): JENNIFER ANN SNELL CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8308 OHIO RIVER RD STE B
WHEELERSBURG OH
45694-1713
US

IV. Provider business mailing address

8308 OHIO RIVER RD STE B
WHEELERSBURG OH
45694-1713
US

V. Phone/Fax

Practice location:
  • Phone: 740-529-1201
  • Fax: 740-876-8854
Mailing address:
  • Phone: 740-529-1201
  • Fax: 740-876-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.192738
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: