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General NPI Number Information
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NPI Number | 1407672140
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Entity Type | Organization
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Legal Business Name | MD SNOW PM COUNSELLING
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 1911 APPIANWAY ST
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City | LITTLE ROCK
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State | AR
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Zip | 72204-4165
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Country | US
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Telephone | 501-313-1118
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Fax | 501-568-1453
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Provider Business Mailing Address
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Address Line | 1911 APPIANWAY ST
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City | LITTLE ROCK
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State | AR
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Zip | 72204-4165
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Country | US
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Telephone | 501-313-1118
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Fax | 501-568-1453
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Authorized Official
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Title or Position | MANAGER
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Name | MARCIE SNOW
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Credential | LADAC
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Telephone | 501-313-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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