MEDICARE: MS. TERESA TONTA MICHELLE 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	101YP2500X	Professional Counselor	LPC015874	GA

General Provider Information

NPI Number	:	1336850445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA TONTA MICHELLE SNOW

Provider Business Mailing Address
First Line	:	605 ATHENS HWY UNIT 5-201
Second Line	:
City	:	LOGANVILLE
State	:	GA
Zip	:	30052-4767
Country	:	US
Telephone Number	:	404-740-4910
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 ATHENS HWY UNIT 5-201
Second Line	:
City	:	LOGANVILLE
State	:	GA
Zip	:	30052-4767
Country	:	US
Telephone Number	:	404-740-4910
Fax Number	:

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

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	01/17/2026

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