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General NPI Number Information
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NPI Number | 1558418293
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Entity Type | Individual
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Provider Name | E. FRED SNOW LCPC
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1214 12TH AVE S
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City | NAMPA
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State | ID
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Zip | 83651-4665
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Country | US
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Telephone | 208-468-0902
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Fax | 208-330-1024
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Provider Business Mailing Address
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Address Line | 5303 S POWERLINE RD
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City | NAMPA
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State | ID
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Zip | 83686-8902
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Country | US
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Telephone | 208-468-0902
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Fax | 208-330-1024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 81
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License Number State | ID
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