Provider Demographics
NPI:1033329263
Name:SNOW, LAUREL (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CUSHING BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6140
Mailing Address - Country:US
Mailing Address - Phone:207-865-9420
Mailing Address - Fax:207-865-9420
Practice Address - Street 1:2 CUSHING BRIGGS RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-6140
Practice Address - Country:US
Practice Address - Phone:207-865-9420
Practice Address - Fax:207-865-9420
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC110811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical