Provider Demographics
NPI:1538501713
Name:SNOW, EMILY (PC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 CINCINNATI AVE
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-5071
Mailing Address - Country:US
Mailing Address - Phone:937-427-3837
Mailing Address - Fax:937-376-8725
Practice Address - Street 1:452 W MARKET ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2815
Practice Address - Country:US
Practice Address - Phone:937-376-8700
Practice Address - Fax:937-376-8725
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1000145101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor