Provider Demographics
NPI:1598418006
Name:SNOW, KATHERINE (MA, ATR-P)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:MA, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 N MAGNOLIA AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3484
Mailing Address - Country:US
Mailing Address - Phone:708-205-6723
Mailing Address - Fax:
Practice Address - Street 1:2045 W NORTH AVE STE 2A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5413
Practice Address - Country:US
Practice Address - Phone:773-340-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health