MEDICARE: SAMANTHA NOEL SNOW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	101Y00000X	Counselor

General Provider Information

NPI Number	:	1326544016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA NOEL SNOW

Provider Business Mailing Address
First Line	:	2607 CADDO ST STE K
Second Line	:
City	:	ARKADELPHIA
State	:	AR
Zip	:	71923-5354
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 HIGHWAY 8 E
Second Line	:
City	:	AMITY
State	:	AR
Zip	:	71921-8562
Country	:	US
Telephone Number	:	870-356-2912
Fax Number	:

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

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	04/02/2018

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Directions to “ SAMANTHA NOEL SNOW ” Practice Location

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