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General NPI Number Information
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NPI Number | 1467384727
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Entity Type | Organization
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Legal Business Name | EMBODIED THERAPY PLLC
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 857 NATURE RD
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City | BOONE
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State | IA
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Zip | 50036-7288
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Country | US
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Telephone | 515-320-8370
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Fax |
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Provider Business Mailing Address
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Address Line | 857 NATURE RD
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City | BOONE
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State | IA
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Zip | 50036-7288
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Country | US
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Telephone | 515-320-8370
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SUPERVISOR
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Name | SAMANTHA SNOVELLE
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Credential | LMHC
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Telephone | 515-520-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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