Provider Demographics
NPI:1891495180
Name:SNOW, SEQUOYA (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:SEQUOYA
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FINSBURY ST APT 4309
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7631
Mailing Address - Country:US
Mailing Address - Phone:919-699-9956
Mailing Address - Fax:
Practice Address - Street 1:4819 EMPEROR BLVD STE 447G
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-0089
Practice Address - Country:US
Practice Address - Phone:919-699-9956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
A-3881171171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach