Provider Demographics
NPI:1477623932
Name:SNOW, HEIDI L (CSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:SNOW
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7636 S 1300 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4135
Mailing Address - Country:US
Mailing Address - Phone:801-566-7688
Mailing Address - Fax:
Practice Address - Street 1:132 S STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1506
Practice Address - Country:US
Practice Address - Phone:801-240-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6221478-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker