Healthcare Provider Details

I. General information

NPI: 1093033888
Provider Name (Legal Business Name): SNOW R DONMOYER L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12518 OLD PEE DEE RD
HEMINGWAY SC
29554-4309
US

IV. Provider business mailing address

12518 OLD PEE DEE RD
HEMINGWAY SC
29554-4309
US

V. Phone/Fax

Practice location:
  • Phone: 843-558-5319
  • Fax:
Mailing address:
  • Phone: 843-558-5319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 4308
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: