Provider Demographics
NPI:1962457754
Name:SNOW, CATHERINE (PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4650
Mailing Address - Country:US
Mailing Address - Phone:919-782-4981
Mailing Address - Fax:919-782-2474
Practice Address - Street 1:4000 BLUE RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4650
Practice Address - Country:US
Practice Address - Phone:919-782-4981
Practice Address - Fax:919-782-2474
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1820103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0425COtherBCBS PROVIDER NUMBER