MEDICARE: LATISHA SNOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1063081248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATISHA SNOW

Provider Business Mailing Address
First Line	:	431 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-5533
Country	:	US
Telephone Number	:	614-487-8758
Fax Number	:

Provider Business Practice Location Address
First Line	:	2234 S HAMILTON RD STE 103
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4389
Country	:	US
Telephone Number	:	614-571-1486
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	04/05/2024

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Directions to “ LATISHA SNOW ” Practice Location

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