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NPI Code Detail

MEDICARE: KIMNETTA SNOWDEN LCSW

MEDICARE: KIMNETTA SNOWDEN 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 Worker6801096229MI
21041C0700XClinical Social Worker34008280AIN

General Provider Information

NPI Number : 1326436718
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMNETTA SNOWDEN LCSW
Provider Business Mailing Address
First Line : 9615 E 148TH ST STE 1
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4371
Country : US
Telephone Number : 317-587-0500
Fax Number :
Provider Business Practice Location Address
First Line : 2506 WILLOWBROOK PKWY STE 300
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1500
Country : US
Telephone Number : 317-574-1254
Fax Number : 317-674-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2015
Last Update Date : 10/24/2018

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Directions to “ KIMNETTA SNOWDEN LCSW” Practice Location

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