Provider Demographics
NPI:1356687727
Name:SNOW, JOANNE MATTIO (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:MATTIO
Last Name:SNOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:ROSE
Other - Last Name:MATTIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:11 W. VICTORY WAY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625
Mailing Address - Country:US
Mailing Address - Phone:970-824-5552
Mailing Address - Fax:970-824-5555
Practice Address - Street 1:11 W. VICTORY WAY
Practice Address - Street 2:SUITE 209
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625
Practice Address - Country:US
Practice Address - Phone:970-824-5552
Practice Address - Fax:970-824-5555
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9919781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical