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NPI Code Detail

MEDICARE: TERESA MARIE SNELL LCSW

MEDICARE: TERESA MARIE SNELL LCSW
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
11041C0700XClinical Social WorkerR037427NY

General Provider Information

NPI Number : 1063565117
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA MARIE SNELL LCSW
Provider Business Mailing Address
First Line : 150 ALLENS CREEK RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3308
Country : US
Telephone Number : 585-442-1269
Fax Number :
Provider Business Practice Location Address
First Line : 150 ALLENS CREEK RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3308
Country : US
Telephone Number : 585-442-1269
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2007
Last Update Date : 07/08/2007

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Directions to “ TERESA MARIE SNELL LCSW” Practice Location

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